Researchers have developed a predictive model to help identify the presence of hip abductor tears in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome.
New Predictive Model Identifies Predictors of Hip Abductor Tears
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Secondary#chondraldamage#hipabductortears#femalesex
In the study, “Development of a Predictive Algorithm for Symptomatic Hip Abductor Tears in Patients Undergoing Primary Hip Arthroscopy,” published online on January 6, 2021 in The American Journal of Sports Medicine, Benjamin Domb, M.D., founder and chair of the American Hip Institute Research Foundation and colleagues developed a predictive algorithm for hip abductor tears which can be difficult to diagnose.
They hypothesized that body mass index, female sex, age, and presence of chondral damage would be important predictors of hip abductor pathologies.
Data on patients who underwent primary hip arthroscopy for femoroacetabular impingement syndrome between March 2009 and December 2019 was collected. And a total of 255 hips were included in the analysis. The researchers excluded patients with Tönnis grade greater than 1, previous hip conditions, incomplete radiographic data, or open procedures.
From the data, Dr. Domb and his team created a predictive model using age, sex, body mass index, lateral joint space, and alpha angle as variables. The model was 90.7% effective with an area under the curve of 0.894.
The odds of having a hip abductor tear were 7.41 times higher in females (odds ratio [OR], 7.41; 95% CI, 1.01-1.06).
“This study successfully created a predictive model that identified female sex (OR, 7.41), increasing age (OR, 1.13) for each year), and increased BMI (OR, 1.034 for each unit of BMI) as significant independent predictors of the presence of hip abductor tears in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome. This model can be used in support of physical examination and imaging suggestive of hip abductor pathology to preoperatively identify the probability of a symptomatic hip abductor tear in these patients,” the study authors wrote.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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