Outcomes of 1038 Hip Arthroscopies

Abstract

Objectives:The purpose of this study was to evaluate clinical outcomes, pain, and patient satisfaction following all hip arthroscopies performed by a single surgeon at a high volume referral center with a mean 2-year follow-up.Methods:During the study period, February 2008 to June 2012, data were collected on all patients undergoing hip arthroscopy. All patients were assessed pre- and post-operatively with 4 patient-reported outcome (PRO) measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sport Specific Subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. The number of patients who underwent revision arthroscopy, total hip arthroplasty, or a resurfacing procedure during the study period is also reported for primary and revision hip arthroscopies.Results:One thousand and thirty eight patients underwent hip arthroscopy during the study period. The score improvement from preoperative to 2-year follow-up was 60.9 to 77.6 for mHHS, 62.8 to 78.9 for HOS-ADL, 40.0 to 63.43 for HOS-SSS, 57.4 to 76.2 for NAHS. VAS decreased from 5.86 preoperatively to 3.15 postoperatively. All scores demonstrated statistically significant improvement (p<0.001). Overall patient satisfaction was 7.57. One hundred and seven (10.3%) patients underwent revision hip arthroscopy during the study period. Sixty-three (6.07%) patients underwent either total hip arthroplasty (THA) or hip resurfacing (HR) procedures during the study period. Of these, 51 (5.48%) were after primary hip arthroscopies and 12 (11.2%) were after revision hip arthroscopies suggesting a relative risk of 2.05 for a THA/HR after revision procedures. Figure 1 shows a Kaplan-Meier survivorship curve for patients who underwent primary and revision hip arthroscopies with THA/HR. The overall complication rate was 5.5%.Conclusion:Hip arthroscopy for all indications results in improved clinical outcomes, decreased pain, and high satisfaction at a mean 2-year follow-up. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty, and the potential for revision surgery.