Outcomes of Femoral Head Marrow Stimulation Techniques at Minimum 2-Year Follow-up
Abstract
This study compared patients who underwent femoral head microfracture with a control group of patients who did not require microfracture. Patients had more than 2 years of follow-up. The patient groups had similar demographic and radiographic features, including sex, age within 5 years, body mass index within 5 points, equal Tönnis grade, lateral center edge angle within 5°, labral treatment, and capsular closure vs release. Inclusion criteria were a minimum of 2 years of follow-up, Outerbridge grade IV cartilage damage, and femoral head marrow stimulation technique performed at the time of arthroscopy. Exclusion criteria were revision surgery, dysplasia, Tönnis grade of greater than 1, protrusio or profunda acetabuli, Perthes disease of the hip, slipped capital femoral epiphysis, abductor tear, and avascular necrosis of the hip. Patient-reported outcomes included modified Harris hip score, nonarthritic hip score, hip outcome score-activity of daily living subscale, hip outcome score-sports subscale, and visual analog scale score for pain. Fifteen patients had femoral head microfracture with more than 2 years of follow-up. Mean improvements in modified Harris hip score, nonarthritic hip score, hip outcome score-sports subscale, and visual analog scale score were 17.1, 19.4, 30.5, and 2.8, respectively, for the microfracture group compared with 11.8, 18.5, 22.2, and 3.0, respectively, for the control group. Both groups showed statistically significant improvement (P<.05) for all patient-reported outcomes, and no significant difference was found between the 2 patient groups at latest follow-up. Two patients in the microfracture group vs 3 patients in the control required hip arthroplasty. Femoral head microfracture is a technically difficult procedure, but when performed correctly, the results are similar to those of patients who do not require microfracture. Further study of femoral head microfracture is necessary to confirm these encouraging short-term outcomes. [Orthopedics. 2018; 41(1):e70-e76.].