Treatment of the Wave Sign With Femoral Osteoplasty With and Without Chondrolabral Stabilization Using Suture Anchors

Arthroscopy. 2021 Apr;37(4):1155-1160. doi: 10.1016/j.arthro.2020.11.048. Epub 2020 Dec 2.

Abstract

Purpose: To discuss the surgical outcomes of patients identified to have the wave sign without an accompanying labral tear treated with and without stabilization of the chondrolabral junction in conjunction with femoral osteoplasty.

Methods: A retrospective study was performed in patients with cartilage delamination (wave sign) treated with femoral osteoplasty alone (FO group) or femoral osteoplasty with chondrolabral stabilization (CLS group). Patient-reported outcomes including the modified Harris Hip Score, Hip Outcome Score (HOS)-Activities of Daily Living, and HOS-Sports-Specific Subscale were obtained at a minimum of 2 years postoperatively. Other outcomes included rates of revision hip arthroscopy and conversion to hip arthroplasty.

Results: The study consisted of 47 patients in the FO group and 38 in the CLS group. Both groups showed significant increases in all patient-reported outcomes over the study period compared with preoperative values. The final modified Harris Hip Score was 72.8 ± 9.2 in the FO group and 79.9 ± 9.3 in the CLS group (P < .001). The HOS-Activities of Daily Living in the FO and CLS groups was 81.4 ± 10.3 and 87.2 ± 7.5, respectively (P < .001). There was no difference in the HOS-Sports-Specific Subscale between the FO group (74.4 ± 10.3) and the CLS group (78.0 ± 14.6) at final follow-up (P = .198). Revision hip arthroscopy was required in 5 patients in the FO group (13%) and 3 in the CLS group (6.3%). No patient in either group required conversion to hip arthroplasty throughout the study period.

Conclusions: Chondrolabral stabilization in conjunction with femoral osteoplasty is an effective treatment in patients with the wave sign without labral tears.

Level of evidence: Level III, retrospective cohort study.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Arthroplasty*
  • Arthroscopy
  • Cartilage / surgery
  • Female
  • Femur / diagnostic imaging
  • Femur / surgery*
  • Hip Joint / diagnostic imaging
  • Hip Joint / surgery
  • Humans
  • Male
  • Patient Reported Outcome Measures
  • Retrospective Studies
  • Suture Anchors*
  • Treatment Outcome