Hip arthroscopy following contralateral total hip arthroplasty: a multicenter matched-pair study.

Karan A Patel,Benjamin G Domb,David E Hartigan,John M Redmond,Bruce A Levy,Aaron J Krych

doi:10.1093/jhps/hny047

Karan A Patel, Benjamin G Domb + Show 4 more

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https://doi.org/10.1093/jhps/hny047

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Abstract

ABSTRACTThe purpose of this study was to determine if patients undergoing hip arthroscopy for labral pathology with contralateral total hip arthroplasty (THA) have a difference in revision surgeries or patient-reported outcomes (PROs) when compared with those patients undergoing hip arthroscopy for labral pathology with a native contralateral hip. A retrospective review was performed for patients that were undergoing hip arthroscopy between 2008 and 2015. Patients were included in the study group if they met the following inclusion criteria: Tönnis Grade 0 or 1, hip labral pathology, previous contralateral THA, and greater than 2-year follow-up with completion of all PROs or conversion to a THA. Exclusion criteria included the previous surgical history on ipsilateral hip, peritrochanteric or deep gluteal space arthroscopy performed concomitantly, or dysplasia [Lateral Center Edge Angle (LCEA) < 20°]. A 3:1 matched-pair study was conducted. Multiple PRO scores were recorded for both groups. There was no statistically significant difference in the modified Harris hip score, non-arthritic hip score, hip outcome score-sports specific sub-scale, visual analog pain score and patient satisfaction scores between both groups. However, the study group was noted to have six patients converted to THA (67%) at an average of 30 months post-operatively, compared with only four patients (15%) in the control group (P = 0.006). Hip arthroscopy cannot be currently recommended in patients who have undergone contralateral THA due to the high conversion to THA (67%).

Highlights

Total hip arthroplasty (THA) is one of the most common and successful orthopedic procedures performed worldwide
The following was retrieved from the chart review: procedure performed, intraoperative findings [labral tear type, Outerbridge score [28] and Ligamentum Teres status (Villar class, Domb class)] [29], secondary operation, patient-reported outcomes (PROs), visual analog pain score (VAS) and patient satisfaction in both the control and study group
There was no statistical difference between the study group and control group for laterality, gender, age, BMI, followup time, Tonnis grade or Lateral Center Edge Angle (LCEA) (Table I)

Summary

Introduction

Total hip arthroplasty (THA) is one of the most common and successful orthopedic procedures performed worldwide. The improvement in technology and technique of hip arthroscopy has enabled treatment of pathology at an earlier age, in hopes of preventing the continued degeneration of the joint due to offending osseous and soft tissue pathoanatomy. Hip arthroscopy continues to gain popularity as there is strong evidence for patient improvement following arthroscopy [13,14,15,16,17,18,19,20,21,22,23]. As indications for hip arthroscopy continue to expand, an increasing number of aging patients meet criteria for this intervention and are not yet candidates for THA. Risk factors for failure of hip arthroscopy include obesity, decreased joint space (

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