Background: Previous studies have identified predictors of total hip arthroplasty (THA) conversion after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) at short- to midterm follow-up, yet no studies to the authors’ knowledge have established a scoring system for predicting THA conversion at a minimum 10-year follow-up. Purpose: To create a scoring system to predict 10-year THA conversion after contemporary HA for FAIS. Study Design: Case-control study; Level of evidence, 3. Methods: Data were prospectively collected from patients undergoing primary contemporary HA for FAIS, including labral repair, osteoplasty of FAIS deformity, and capsular repair, between January 2012 and October 2013, with a minimum 10-year follow-up. Patients who underwent THA conversion were compared with patients who achieved 10-year THA-free survivorship. Significant predictors of THA conversion were identified, and predictor weights were assigned to create the THA-10 score. The score was applied to the cohort, and its clinical utility was evaluated. The threshold score with the greatest sensitivity and specificity for predicting 10-year THA conversion was identified. Results: In total, 280 patients were included; 21 (7.5%) underwent THA conversion by the 10-year follow-up. Patients who underwent THA conversion were of older age (45.4 ± 11.3 vs 33.2 ± 12.1 years; P < .001), had a greater body mass index (28.0 ± 5.2 vs 24.8 ± 4.7 kg/m 2 ; P = .011), and had a greater prevalence of Tönnis grade 1 osteoarthritis (42.9% vs 14.3%; P = .003) and high-grade acetabular (61.9% vs 12.7%; P < .001) and femoral head (33.3% vs 7.3%; P < .001) chondral defects compared with THA-free survivors. After variable weighting, the THA-10 score was established as 1 point for body mass index ≥25 kg/m 2 , 1 point for Tönnis grade 1, 2 points for age ≥47 years, and 3 points for high-grade defects of the acetabulum or femoral head. The THA-10 score was found to have clinically significant diagnostic value with an area under the receiver operating characteristic curve of 0.823. Patients scoring ≥4 points were 13.2 times more likely to undergo THA conversion (95% CI, 5.0-35.1; P < .001). Conclusion: This study created the THA-10 score and showed it to have clinically significant diagnostic utility in predicting 10-year THA conversion after HA for FAIS. Patients scoring ≥4 points were 13.2 times more likely to undergo THA conversion.

中文翻译：

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在至少 10 年的随访中，预测现代髋关节镜检查后股骨髋臼撞击综合征转化为全髋关节置换术的 THA-10 评分


背景： 以前的研究已经确定了短期到中期随访中髋关节镜检查 （HA） 后股骨髋臼撞击综合征 （FAIS） 的全髋关节置换术 （THA） 转换的预测因子，但据作者所知，没有研究建立预测至少 10 年随访中 THA 转换的评分系统。目的：创建一个评分系统来预测 FAIS 的当代 HA 后 10 年 THA 转换。研究设计： 病例对照研究;证据水平，3.方法： 前瞻性收集 2012 年 1 月至 2013 年 10 月期间接受原发性当代 HA 治疗 FAIS 的患者的数据，包括盂唇修复、FAIS 畸形骨成形术和关节囊修复术，随访至少 10 年。将接受 THA 转换的患者与实现 10 年无 THA 生存期的患者进行比较。确定了 THA 转化率的重要预测因子，并分配了预测因子权重来创建 THA-10 评分。将分数应用于队列，并评估其临床效用。确定了预测 10 年 THA 转换的敏感性和特异性最高的阈值评分。结果： 共纳入 280 例患者;21 例 （7.5%） 在 10 年随访中接受了 THA 转化。接受 THA 转换的患者年龄较大 （45.4 ± 11.3 vs 33.2 ± 12.1 岁;P < .001），体重指数较高 （28.0 ± 5.2 vs 24.8 ± 4.7 kg/m 2 ;P = .011），并且 Tönnis 1 级骨关节炎的患病率更高 （42.9% 对 14.3%;P = .003） 和高级别髋臼 （61.9% 对 12.7%;P < .001） 和股骨头 （33.3% 对 7.3%;P < .001） 软骨缺损与无 THA 的幸存者相比。 可变权重后，THA-10 评分确定为体重指数 ≥25 kg/m 2 为 1 分，Tönnis 1 级为 1 分，年龄为 ≥47 岁为 2 分，髋臼或股骨头高级缺损为 3 分。发现 THA-10 评分具有临床意义的诊断价值，受试者工作特征曲线下面积为 0.823。得分 ≥4 分的患者接受 THA 转换的可能性是 13.2 倍 （95% CI，5.0-35.1;P < .001）。结论： 本研究创建了 THA-10 评分，并表明它在预测 FAIS 的 HA 后 10 年 THA 转换方面具有临床意义的诊断效用。得分 ≥4 分的患者发生 THA 转换的可能性要高 13.2 倍。