Role of Arthroscopy for Hip Osteoarthritis with Impingement

Abstract

Femoroacetabular impingement (FAI), also known as hip impingement, has seen increasing attention over the last decade. This condition is being recognized as a cause hip pain and can lead to early degeneration within the joint. The purpose of this review is to examine the current literature related to the treatment of FAI combined with osteoarthritis (OA) with hip arthroscopy. FAI without degenerative changes is effectively treated with hip arthroscopy, osteoplasty, and labral repair. While there is still a role for hip arthroscopy in lower grades of OA, higher grades of OA or joint space of less than 2 mm have been shown in the literature to result in poor outcomes and early failure. OA has been shown to be a risk factor for failure of hip arthroscopy independent of age. There is limited role for hip arthroscopy in the presence of OA. Careful patient selection, stringent surgical indications, and selection criteria, as well as consideration for overall cost-benefit in older patients and patients with pre-existing OA are imperative. Future research should evaluate whether definitive total hip arthroplasty is more cost-effective than joint preserving surgeries in the presence of FAI with mild OA.