Post-Treatment Classification for Acetabular Chondral Lesions in Hip Arthroscopy

Polesello, Giancarlo Cavalli; Viamont-Guerra, Maria-Roxana; Zego, Fábio; Rabelo, Nayra Deise dos Anjos; Ricioli, Walter; Queiroz, Marcelo Cavalheiro

doi:10.1055/s-0039-1693049

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Revista Brasileira de Ortopedia

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Sumário

Artigo Original • Rev. bras. ortop. 54 (6) • Nov-Dec 2019 • https://doi.org/10.1055/s-0039-1693049 copy

Post-Treatment Classification for Acetabular Chondral Lesions in Hip Arthroscopy^* * Work performed at the Hip Group, Orthopedics and Traumatology Department, Irmandade Santa Casa de Misericórdia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To describe a postarthroscopic treatment classification system for acetabular chondral damage in the hip and to report the intraobserver and interobserver reliability of such classification.

Methods

This is a retrospective review of ninety-nine digital video recordings made during arthroscopic surgery. Patients who underwent arthroscopic treatment for femoroacetabular impingement and evaluated at the hip arthroscopy outpatient clinic between March 2015 and March 2016 were included in the study. Patients with a history of previous hip surgery, radiologic evidence of advanced osteoarthritis (Tönnis grade > 2), who underwent labral resection, or whose digital recordings were incomplete or of insufficient quality for adequate review were excluded. Two orthopedic surgeons, who did not participate in the surgery, independently reviewed the video recordings and classified the remaining acetabular cartilage using the post-treatment classification system. Intraobserver and interobserver analysis was then conducted using intraclass correlation coefficient (ICC).

Results

Excellent intraobserver reliability (ICC = 0.790; p < 0.001) and interobserver reliability (ICC = 0.882; p < 0.001) were observed. Both ICC values were statistically significant.

Conclusion

The posttreatment classification of the remaining acetabular cartilage has excellent intra and interobserver reliability.

Keywords
arthroscopy; hip injuries; chondrocytes/classification; treatment outcome

Type		Description of the remaining acetabular cartilage
1		The chondral lesion was completely removed, and the remaining cartilage appears normal
2		The remaining cartilage appears abnormal (surface roughness, malacia, fibrillation, surface roughness or any change without subchondral bone exposure)
3		Remaining area of exposed bone < 2 cm2^* * square centimeters.
4		Remaining area of exposed bone > 2 cm²

	Observer 1^* * values indicate number of cases.		Observer 2^* * values indicate number of cases.
	1^st evaluation	2^nd evaluation	Observer 2^* * values indicate number of cases.
Type 1	17	20	17
Type 2	48	47	51
Type 3	22	26	23
Type 4	12	6	8

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] Address for correspondence, Giancarlo Cavalli Polesello, Rua Dr Cesário Mota Júnior, 112, Bairro Vila Buarque, São Paulo, SP, 01221- 020, Brazil. (e-mail: dot.quadril@hotmail.com).

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Post-Treatment Classification for Acetabular Chondral Lesions in Hip Arthroscopy* * Work performed at the Hip Group, Orthopedics and Traumatology Department, Irmandade Santa Casa de Misericórdia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.

Abstract

Objective

Methods

Results

Conclusion

Post-Treatment Classification for Acetabular Chondral Lesions in Hip Arthroscopy^* * Work performed at the Hip Group, Orthopedics and Traumatology Department, Irmandade Santa Casa de Misericórdia, Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.