ePoster #1204 - ISHA Annual Scientific Meeting 2016

Clinical Outcomes Of Femoral Head Microfracture: A Group-Matched Controlled Study With Minimum Two-Year Follow-Up

David E. Hartigan, MD, Westmont, IL UNITED STATES
Itay Perets, MD, Westmont, IL UNITED STATES
Edwin Chaharbakhshi, BS, Hinsdale, IL UNITED STATES
John P. Walsh, MA, Westmont, IL UNITED STATES
Mary R. Close, BS, Westmont, IL UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Westmont, IL, UNITED STATES

FDA Status Not Applicable

Summary: Femoral head microfracture is a technically difficult procedure, but when performed correctly, patient reported outcomes, satisfaction scores, future surgeries are similar to patients who did not require microfracture.

Abstract:
Background: Microfracture has been a successful procedure in the hip with documented improvement in PRO, VAS, and high patient satisfaction. All studies to date on hip microfracture have predominantly examined acetabular microfracture, and no study has reported exclusively on the results of femoral head microfracture. Purpose: The purpose of this study was to compare the results of patients who underwent femoral head microfracture to a control group who did not require microfracture with greater than two years of follow-up. Methods: Between February 2008 and September 2013, there were 15 patients with greater than two-year outcomes after femoral head microfracture at our institution. Exclusion criteria included Tönnis grade greater than one, LCEA <20, inflammatory arthritis of the hip, pre-existing pediatric hip conditions, coxa profunda or protrusio, and abductor repair. A 3:1 group match was performed based on age, gender, BMI, radiographs, and procedures performed. Patient reported outcomes (PROs) including visual analog scale (VAS) for pain, modified-Harris hip score (mHHS), non-arthritic hip score (NAHS), and hip outcome score-sports specific subscale (HOS-SSS) were collected preoperatively and postoperatively at three months and annually thereafter. Patients were asked how satisfied they were on a scale of one to ten. The need for hip arthroplasty and radiographic progression of Tönnis grade were recorded. Results: Fifteen patients had femoral head microfracture with greater than two year follow-up. The average improvements in mHHS, NAHS, HOS-SSS and VAS were 17, 19, 30, and 2.8 in the microfracture group as compared to 12, 17, 21, and 3 in the control group. Both groups showed statistically significant improvement (p<0.05) in all PROs, and no difference was found between the microfracture group and control group. Hip arthroplasty was required in two patients in the microfracture group as compared to two patients in the control group. There was no progression of Tönnis grade in either group. Conclusion: Femoral head microfracture is a technically difficult procedure, but when performed correctly results are similar to patients who did not require microfracture. Further study of femoral head microfracture is necessary to continue to support these encouraging outcomes.