Effect of the presence of cysts in the hip joint on hip arthroscopy
Murat Çiçeklidağ1
, Tacettin Ayanoğlu2, Ahmet Yiğit Kaptan3, Abdurrahman Vural4, Oya Kalaycıoğlu5, Mustafa Özer6, Ulunay Kanatlı7
1Department of Orthopedics and Traumatology, Yenimahalle Training and Research Hospital, Ankara, Türkiye
2Department of Orthopedics and Traumatology, Abant İzzet Baysal University Faculty of Medicine, Bolu, Türkiye
3Department of Orthopedics and Traumatology, Harran University Faculty of Medicine, Şanlıurfa, Türkiye
4Department of Orthopedics and Traumatology, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
5Department of Biostatistics and Medical Informatics, Abant İzzet Baysal University Faculty of Medicine, Bolu, Türkiye
6Department of Orthopedics and Traumatology, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
7Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Türkiye
Keywords: Acetabular cyst, femoral cyst, hip arthroscopy, impingement, subchondral cyst.
Abstract
Objectives: The aim of this study was to investigate whether the presence and size of fibrous cysts affected postoperative results in patients undergoing hip arthroscopy.
Patients and methods: Between January 2010 and December 2019, a total of 261 patients (138 males, 123 females; mean age: 39.5±11.9 years; range, 18 to 66 years) who underwent hip arthroscopy with the diagnosis of cam-pincer-mixed-type femoroacetabular impingement (FAI) and labral pathologies were retrospectively analyzed. The study groups (impingements and labral pathologies) and the presence of cyst (or cyst size: <5 mm, 5-8 mm, >8 mm) were used as the fixed effects, and the analysis was adjusted for baseline age, sex, and preoperative scores. Pre- and postoperative modified Harris Hip Score (mHHS) and Visual Analog Scale (VAS) scores that were applied to all patients were used as an indication of clinical results.
Results: The mean preoperative mHHS score of the patients with a cyst was significantly lower compared to the patients without a cyst (56.8±12.3 vs. 60.3±12.7, p=0.026). The mean change in the mHHS score and the mean percentage change in VAS score were significantly higher in the patients with a cyst compared to the patients without a cyst (mHHS score: 28.1±14.0 vs. 22.5±14.1, p=0.002; VAS score: 61.9±30.2 vs. 52.6±47.4, p=0.038). The increase in mHHS score over time for patients with a cyst was significantly higher than the patients without cysts in the pincer group (38.1±11.1 vs. 19.3±13.5, p<0.001). The patients with a cyst size of >8 mm had a significantly higher increase in the mHHS scores compared to the patients with a cyst size of <5 mm (29.5±12.9 vs. 23.5±13.8, p=0.043).
Conclusion: Subchondral cysts in the femoral head and neck junction accompanied cam-type and mixed-type FAI, while subchondral cysts in the acetabulum accompanied pincer-type impingement. In all groups, the mean increase in mHHS scores and the mean decrease in VAS scores were higher in patients with subchondral cysts than in patients without cysts. In patients with subchondral cysts, if the lesion causing FAI is treated arthroscopically, it can positively affect the functional results.
Citation: Çiçeklidağ M, Ayanoğlu T, Kaptan AY, Vural A, Kalaycıoğlu O, Özer M, et al. Effect of the presence of cysts in the hip joint on hip arthroscopy. Jt Dis Relat Surg 2024;35(3):645-653. doi: 10.52312/jdrs.2024.1657.
The study protocol was approved by the Gazi University Clinical Research Ethics Committee (date: 18.10.2021, no: 15). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Idea, study design, figures: M.Ç., T.A., U.K.; Data collection, materials: M.Ç., A.V.; Control/ supervision: M.Ö., U.K; Analysis and/or interpretation: O.K., T.A.;Literature review, critical review: M.Ç., A.Y.K., T.A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.