Martin Scott D, Dowley Kieran S, Siddiq Bilal S, Gillinov Stephen M, Lee Jonathan S, Cherian Nathan J, Eberlin Christopher T, Kucharik Michael P, Dean Michael C
Department of Orthopaedic Surgery, Sports Medicine Service, Massachusetts General Hospital, Boston, Massachusetts.
Department of Orthopaedic Surgery, University of Nebraska, Omaha, Nebraska.
J Bone Joint Surg Am. 2025 May 30;107(14):1570-1578. doi: 10.2106/JBJS.24.00602.
Bone marrow aspirate concentrate (BMAC) augmentation at the time of hip arthroscopy is a potential solution to improve functional outcomes in patients with cartilage damage concomitant with acetabular labral tearing; however, follow-up functional scores to date have not exceeded 24 months. Therefore, the present study compares minimum 5-year outcomes in patients treated with or without BMAC augmentation to address chondral damage during arthroscopic labral repair.
This was a prospective cohort study analyzing patients who underwent acetabular labral repair performed by a single surgeon. Patients were stratified into either the BMAC cohort or the control cohort depending on whether BMAC was utilized in conjunction with arthroscopic labral repair. Demographic and intraoperative variables, including chondrolabral junction breakdown and articular cartilage damage, were compared between cohorts, as were patient-reported outcome measures (PROMs) at enrollment and at 3, 6, 12, 24, and 60 months postoperatively.
Eighty-one hips were included for analysis: 39 (38 patients) in the BMAC cohort and 42 (39 patients) in the control cohort. Univariate analyses demonstrated similar baseline characteristics between groups, including body mass index, Tönnis angle, lateral center-edge angle (LCEA), and alpha angle (p > 0.05 for each). Patients treated with BMAC and patients in the control group reported similar PROMs between enrollment and the 12-month follow-up. By the 24-month follow-up, patients treated with BMAC reported significantly higher scores for the modified Harris hip score (mHHS) (p = 0.004), the International Hip Outcome Tool-33 (iHOT-33) (p = 0.012), and the Hip Outcome Score-Activities of Daily Living (HOS-ADL) (p = 0.008). This trend persisted over time, with the BMAC cohort demonstrating significantly higher scores for the mHHS (p < 0.001), iHOT-33 (p = 0.006), and the Hip Outcome Score-Sports Subscale (HOS-SS) (p = 0.012) at 60 months.
Patients undergoing acetabular labral repair with BMAC augmentation reported significantly greater functional improvements compared with patients undergoing repair without BMAC. These differences generally did not become significant until 24 months after surgery, at which point they increased in magnitude until the 60-month follow-up. These findings, the first intermediate-term outcomes reported following hip arthroscopy with BMAC, therefore suggest favorable benefit at an extended follow-up.
Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.
髋关节镜检查时采用骨髓抽吸浓缩物（BMAC）增强术是改善伴有髋臼盂唇撕裂的软骨损伤患者功能结局的一种潜在解决方案；然而，迄今为止的随访功能评分未超过24个月。因此，本研究比较了接受或未接受BMAC增强术治疗的患者至少5年的结局，以解决关节镜下盂唇修复期间的软骨损伤问题。
这是一项前瞻性队列研究，分析由单一外科医生进行髋臼盂唇修复的患者。根据BMAC是否与关节镜下盂唇修复联合使用，将患者分为BMAC队列或对照组。比较队列之间的人口统计学和术中变量，包括软骨盂唇交界处破裂和关节软骨损伤，以及入组时和术后3、6、12、24和60个月时患者报告的结局指标（PROMs）。
纳入81例髋关节进行分析：BMAC队列39例（38例患者），对照组42例（39例患者）。单因素分析显示两组之间的基线特征相似，包括体重指数、Tönnis角、外侧中心边缘角（LCEA）和α角（各p>0.05）。接受BMAC治疗的患者和对照组患者在入组至12个月随访期间报告的PROMs相似。到24个月随访时，接受BMAC治疗的患者在改良Harris髋关节评分（mHHS）（p=0.004）、国际髋关节结局工具-33（iHOT-33）（p=0.012）和髋关节结局评分-日常生活活动（HOS-ADL）（p=0.008）方面的得分显著更高。这种趋势随着时间持续存在，BMAC队列在60个月时在mHHS（p<0.001）、iHOT-33（p=0.006）和髋关节结局评分-运动子量表（HOS-SS）（p=0.012）方面的得分显著更高。
与未接受BMAC增强术的修复患者相比，接受髋臼盂唇修复并采用BMAC增强术的患者报告的功能改善明显更大。这些差异通常在术后24个月才变得显著，此后其幅度不断增加直至60个月随访。因此，这些发现是首次报道的髋关节镜检查联合BMAC后的中期结局，表明在延长随访期有良好益处。
治疗性III级。有关证据水平的完整描述，请参阅作者指南。
