Skip to main content
SpringerLink
Log in

Preoperative risk factors in hip arthroscopy

  • HIP
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Arthroscopic surgery is a usual technique to repair hip femoroacetabular impingement. Correlation exists among surgical indication, postoperative evolution, the final result, and the necessity of prosthesis in the near future. The assessment of specific parameters allowing us to evaluate the prognosis becomes vital to improve the results. The objective of this study is to check the variables found in patients with femoroacetabular impingement (FAI) treated with hip arthroscopy, and determine which of these variables would serve as key indicators in predicting the need for subsequent arthroplasty.

Methods

Data from FAI surgical indications (age, weight, height, BMI, gender, side, radiographic Tönnis degree, cartilage lesion degree by Acetabular Labrum Articular Disruption (ALAD) degree, VAS value, HOS, mHHS and WOMAC) were collected from cases which should have had a minimum monitoring period of 2 years from 2007 to 2017. The results of the group which needed prosthesis were compared to the results of the ones who did not.

Results

Among 452 patients who were monitored for an average of 5.8 years, 82 (18.1%) required conversion to prosthesis. The variables that indicated relatively high risk were fourth-degree acetabular labrum articular disruption (ALAD) chondral injury, preoperative radiographic Grade 2 Tönnis classification, age of over 55 years, WOMAC over 45 points, and HOS-ADL under 50 points. There were no significant differences between side, gender, VAS level, nor HOS.

Conclusions

The presence of chondral injuries such as acetabular labrum articular disruption (ALAD) 4, radiographic Grade 2 Tönnis classification, higher age, higher BMI, and worse WOMAC, along with mHHS and HOS-ADL preoperative results, are factors which lead to a poor prognosis following FAI hip arthroscopic surgery, increasing the risk of prosthetic conversion in the short or medium term.

Level of evidence

Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Agricola R, Heijboer MP, Bierma-Zeinstra SMA, Verhaar JAN, Weinans H, Waarsing JH (2013) Cam impingement causes osteoarthritis of the hip: a nationwide prospective cohort study (CHECK). Ann Rheum Dis 72:918–923

    Article  PubMed  Google Scholar 

  2. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al (1991) The American College of rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34:505–514

    Article  CAS  PubMed  Google Scholar 

  3. Bedard NA, Pugely AJ, Duchman KR, Westermann RW, Gao Y, Callaghan JJ (2016) When hip scopes fail, they do so quickly. J Arthroplasty 31:1183–1187

    Article  PubMed  Google Scholar 

  4. Bozic KJ, Chan V, Valone FH, Feeley BT, Vail TP (2013) Trends in hip arthroscopy utilization in the United States. J Arthroplasty 28(8):140–143

    Article  PubMed  Google Scholar 

  5. Byrd JWT, Jones KS (2010) Prospective analysis of hip arthroscopy with 10-year followup. Clin Orthop Relat Res 468:741–746

    Article  PubMed  Google Scholar 

  6. Byrd JWT, Jones KS (2009) Hip arthroscopy for labral pathology: prospective analysis with 10-year follow-up. Arthroscopy 25(4):365–368

    Article  PubMed  Google Scholar 

  7. Byrd JWT, Jones KS, Gwathmey FW (2016) Femoroacetabular impingement in adolescent athletes. Am J Sports Med 44:2106–2111

    Article  PubMed  Google Scholar 

  8. Callaghan J, Rosenburg A, Rubash H (2007) The adult hip. Lippincott Williams & Wilkins, Philadelphia, p 68

    Google Scholar 

  9. Capogna BM, Ryan MK, Begly JP, Chenard KE, Mahure SA, Youm T (2016) Clinical outcomes of hip arthroscopy in patients 60 or older: a minimum of 2-year follow-up. Arthroscopy 32:2505–2510

    Article  PubMed  Google Scholar 

  10. Chandrasekaran S, Gui C, Darwish N, Lodhia P, Suarez-Ahedo C, Domb BG (2016) Outcomes of hip arthroscopic surgery in patients with Tönnis grade 1 osteoarthritis with a minimum 2-year follow-up. Am J Sports Med 44:1781–1788

    Article  PubMed  Google Scholar 

  11. Comba F, Yacuzzi C, Ali PJ, Zanotti G, Buttaro M, Piccaluga F (2016) Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years. Muscles Ligaments Tendons J 6:317–323

    Article  PubMed  PubMed Central  Google Scholar 

  12. Domb BG, Linder D, Finley Z, Botser IB, Chen A, Williamson J, Gupta A (2015) Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger. Arthroscopy 31:231–238

    Article  PubMed  Google Scholar 

  13. Escobar A, Quintana JM, Bilbao A, Azkárate J, Güenaga JI (2002) Validation of the Spanish version of the WOMAC Questionnaire for patients with hip or knee osteoarthritis. Clin Rheumatol 21:466–471

    Article  CAS  PubMed  Google Scholar 

  14. Fukui K, Briggs KK, Trindade CAC, Philippon MJ (2015) Outcomes after labral repair in patients with femoroacetabular impingement and borderline dysplasia. Arthroscopy 31:2371–2379

    Article  PubMed  Google Scholar 

  15. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120

    Article  Google Scholar 

  16. Gosvig KK, Jacobsen S, Palm H, Sonne-Holm S, Magnusson E (2007) A new radiological index for assessing asphericity of the femoral head in cam impingement. J Bone Joint Surg Br 89:1309–1316

    Article  CAS  PubMed  Google Scholar 

  17. Gupta A, Redmond JM, Hammarstedt JE, Schwindel L, Domb BG (2014) Safety measures in hip arthroscopy and their efficacy in minimizing complications: a systematic review of the evidence. Arthroscopy 30:1342–1348

    Article  PubMed  Google Scholar 

  18. Haefeli PC, Albers CE, Steppacher SD, Tannast M, Büchler L (2017) What are the risk factors for revision surgery after hip arthroscopy for femoroacetabular impingement at 7-year followup? Clin Orthop Relat Res 475:1169–1177

    Article  PubMed  Google Scholar 

  19. Harris JD, McCormick FM, Abrams GD, Gupta AK, Ellis TJ, Bach BR et al (2013) Complications and reoperations during and after hip arthroscopy: a systematic review of 92 studies and more than 6,000 patients. Arthroscopy 29:589–595

    Article  PubMed  Google Scholar 

  20. Haviv B, O’Donnell J (2010) The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients. Sports Med Arthrosc Rehabil Ther Technol. https://doi.org/10.1186/1758-2555-2-18

    Article  PubMed  PubMed Central  Google Scholar 

  21. Herrmann SJ, Bernauer M, Erdle B, Südkamp NP, Helwig P, Hauschild O (2016) Osteoarthritic changes rather than age predict outcome following arthroscopic treatment of femoroacetabular impingement in middle-aged patients. BMC Musculoskelet Disord 17:1–7. https://doi.org/10.1186/s12891-016-1108-6

    Article  Google Scholar 

  22. Jacobsen S, Sonne-Holm S, Søballe K, Gebuhr P, Lund B (2004) The relationship of hip joint space to self reported hip pain. A survey of 4.151 subjects of the Copenhagen City Heart Study: the osteoarthritis substudy. Osteoarthr Cartil 12:692–697

    Article  Google Scholar 

  23. Kaldau NC, Brorson S, Hölmich P, Lund B (2018) Good midterm results of hip arthroscopy for femoroacetabular impingement. Dan Med J 65:4–8

    Google Scholar 

  24. Kemp JL, MacDonald D, Collins NJ, Hatton AL, Crossley KM (2015) Hip arthroscopy in the setting of hip osteoarthritis: systematic review of outcomes and progression to hip arthroplasty. Clin Orthop Relat Res 473:1055–1073

    Article  PubMed  Google Scholar 

  25. Kester BS, Capogna B, Mahure SA, Ryan MK, Mollon B, Youm T (2018) Independent risk factors for revision surgery or conversion to total hip arthroplasty after hip arthroscopy: a review of a large statewide database from 2011 to 2012. Arthroscopy 34:464–470

    Article  PubMed  Google Scholar 

  26. Kowalczuk M, Bhandari M, Farrokhyar F, Wong I, Chahal M, Neely S, Gandhi R, Ayeni OR (2013) Complications following hip arthroscopy: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 21:1669–1675

    Article  CAS  PubMed  Google Scholar 

  27. Langley GB, Sheppeard H (1985) The visual analogue scale: its use in pain measurement. Reumatol Int 5:145–148

    Article  CAS  Google Scholar 

  28. Larson CM, Giveans MR (2009) Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy 25:369–376

    Article  PubMed  Google Scholar 

  29. Londers J, Van Melkebeek J (2007) Hip arthroscopy: outcome and patient satisfaction after 5 to 10 years. Acta Orthop Belg 73:478–483

    PubMed  Google Scholar 

  30. Malviya A, Raza A, Jameson S, James P, Reed MR, Partington PF (2015) Complications and survival analyses of hip arthroscopies performed in the national health service in England: a review of 6,395 cases. Arthroscopy 31:836–842

    Article  PubMed  Google Scholar 

  31. McCarthy B, Ackerman IN, de Steiger R (2018) Progression to total hip arthroplasty following hip arthroscopy. ANZ J Surg 88:702–706

    Article  Google Scholar 

  32. McCarthy JC, Jarrett BSBT, Ojeifo OB, Ann Lee JM, Bragdon CR (2011) What factors influence long-term survivorship after hip arthroscopy? Clin Orthop Relat Res 469:362–371

    Article  PubMed  Google Scholar 

  33. McDonald JE, Herzog MM, Philippon MJ (2014) Performance outcomes in professional hockey players following arthroscopic treatment of FAI and microfracture of the hip. Knee Surg Sports Traumatol Arthrosc 22:915–919

    Article  PubMed  Google Scholar 

  34. Menge TJ, Briggs KK, Dornan GJ, McNamara SC, Philippon MJ (2017) Survivorship and outcomes 10 years following hip arthroscopy for femoroacetabular impingement. J Bone Joint Surg Am 99(12):997–1004

    Article  PubMed  Google Scholar 

  35. Navarro MJ, Ruiz L, Hervás MT, Peiró S, Payá A (2005) Validez de la escala de cadera de Harris en la rehabilitación tras artroplastia de cadera. Rehabilitación 39(4):147–154

    Article  Google Scholar 

  36. Ng VY, Ellis TJ (2011) More than just a bump: Cam-type femoroacetabular impingement and the evolution of the femoral neck. Hip Int 21:1–8. https://doi.org/10.5301/hip.2011.6288

    Article  PubMed  Google Scholar 

  37. O’Leary JA, Berend K, Vail TP (2001) The relationship between diagnosis and outcome in arthroscopy of the hip. Arthroscopy 17:181–188

    Article  PubMed  Google Scholar 

  38. Olach M, Gerhard P, Giesinger K, Lampert C, Erhardt JB (2019) Clinical and radiological outcome at mean follow-up of 11 years after hip arthroscopy. Arch Orthop Trauma Surg. https://doi.org/10.1007/s00402-018-3024-8

    Article  PubMed  Google Scholar 

  39. Palmer AJR, Malak TT, Broomfield J, Holton J, Majkowski L, Thomas GER et al (2016) Past and projected temporal trends in arthroscopic hip surgery in England between 2002 and 2013. BMJ Open Sport Exerc Med 2(1):e000082

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Perets I, Chaharbakhshi EO, Mu B, Ashberg L, Battaglia MR, Yuen LC et al (2018) Hip arthroscopy in patients ages 50 years or older: minimum 5-year outcomes, survivorship, and risk factors for conversion to total hip replacement. Arthroscopy 34:3001–3009

    Article  PubMed  Google Scholar 

  41. Philippon M, Schenker M, Briggs K, Kuppersmith D (2007) Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscopic decompression. Knee Surg Sports Traumatol Arthrosc 15:908–914

    Article  PubMed  PubMed Central  Google Scholar 

  42. Philippon MJ, Briggs KK, Yen Y-M, Kuppersmith DA (2008) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction. J Bone Joint Surg Br 91(1):16–23

    Article  Google Scholar 

  43. Philippon MJ, Briggs Mph KK, Carlisle JC, Patterson Ba DC (2013) Joint space predicts THA after hip arthroscopy in patients 50 years and older. Clin Orthop Relat Res 471(8):2492–2496

    Article  PubMed  PubMed Central  Google Scholar 

  44. Philippon MJ, Ho CP, Briggs KK, Stull J, LaPrade RF (2013) Prevalence of increased alpha angles as a measure of cam-type femoroacetabular impingement in youth ice hockey players. Am J Sports Med 41:1357–1362

    Article  PubMed  Google Scholar 

  45. Philippon MJ, Schroder E, Souza BG, Briggs KK (2012) Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older. Arthroscopy 28:59–65

    Article  PubMed  Google Scholar 

  46. Redmond JM, Gupta A, Cregar WM, Hammarstedt JE, Gui C, Domb BG (2015) Arthroscopic treatment of labral tears in patients aged 60 years or older. Arthroscopy 31:1921–1927

    Article  PubMed  Google Scholar 

  47. Redmond JM, Gupta A, Dunne K, Humayun A, Yuen LC, Domb BG (2017) What factors predict conversion to THA after arthroscopy? Clin Orthop Relat Res 475(10):2538–2545

    Article  PubMed  PubMed Central  Google Scholar 

  48. Sa D, Urquhart N, Philippon M, Ye J-E, Simunovic N, Ayeni OR (2014) Alpha angle correction in femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 22:812–821

    Article  PubMed  Google Scholar 

  49. Sansone M, Ahldén M, Jónasson P, Thomeé C, Swärd L, Öhlin A et al (2017) Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2-year follow-up. Scand J Med Sci Sport 27:230–235

    Article  CAS  Google Scholar 

  50. Schairer WW, Nwachukwu BU, McCormick F, Lyman S, Mayman D (2016) Use of hip arthroscopy and risk of conversion to total hip arthroplasty: a population-based analysis. Arthroscopy 32:587–593

    Article  PubMed  Google Scholar 

  51. Seijas R, Sallent A, Ruiz-Iban MA, Ares O, Marin-Peña O, Cuellar R, Muriel A (2014) Validation of the Spanish version of the hip outcome score: a multicenter study. Health Qual Life Outcomes. https://doi.org/10.1186/1477-7525-12-70

    Article  PubMed  PubMed Central  Google Scholar 

  52. Sing DC, Feeley BT, Tay B, Vail TP, Zhang AL (2015) Age-related trends in hip arthroscopy: a large cross-sectional analysis. Arthroscopy 31:2307-2313.e2

    Article  PubMed  Google Scholar 

  53. Skendzel JG, Philippon MJ, Briggs KK, Goljan P (2014) The effect of joint space on midterm outcomes after arthroscopic hip surgery for femoroacetabular impingement. Am J Sports Med 42:1127–1133

    Article  PubMed  Google Scholar 

  54. Souza BGSE, Dani WS, Honda EK, Ricioli W, Guimarães RP, Ono NK et al (2010) Do complications in hip arthroscopy change with experience? Arthroscopy 26:1053–1057

    Article  PubMed  Google Scholar 

  55. Stevens MS, Legay DA, Glazebrook MA, Amirault D (2010) The evidence for hip arthroscopy: grading the current indications. Arthroscopy 26:1370–1383

    Article  PubMed  Google Scholar 

  56. Tönnis D, Heinecke A (1999) Acetabular and femoral anteversion: relationship with osteoarthritis of the hip. J Bone Joint Surg Am 81(12):1747–1770

    Article  PubMed  Google Scholar 

  57. Tov TB, Amar E, Shapira A, Steinberg E, Atoun E, Rath E (2014) Clinical and functional outcome after acetabular labral repair in patients aged older than 50 years. Arthroscopy 30:305–310

    Article  PubMed  Google Scholar 

  58. Ward JP, Rogers P, Youm T (2012) Failed hip arthroscopy: causes and treatment options. Orthopedics 35:612–617

    Article  PubMed  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

  1. Instituto Cugat, Hospital Quiron Barcelona Floor -1, Pza., Alfonso Comín 5, 08023, Barcelona, Spain

    Roberto Seijas, David Barastegui, Ferran Montaña, Xavier Cuscó, Eduard Alentorn-Geli, Gonzalo Samitier-Solis & Ramón Cugat

  2. Basic Sciences Department, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, Barcelona, Spain

    Roberto Seijas, David Barastegui, Carlos López-de-Celis & Ferran Montaña

  3. Foundation Garcia Cugat, Barcelona, Spain

    Roberto Seijas, David Barastegui, Xavier Cuscó, Eduard Alentorn-Geli, Gonzalo Samitier-Solis & Ramón Cugat

  4. Mutualidad Catalana de Futbolistas, Federación Española de Fútbol, Ronda Sant Pere 19-21, 08010, Barcelona, Spain

    David Barastegui, Eduard Alentorn-Geli & Ramón Cugat

Authors
  1. Roberto Seijas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Barastegui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carlos López-de-Celis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ferran Montaña
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Xavier Cuscó
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eduard Alentorn-Geli
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gonzalo Samitier-Solis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ramón Cugat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roberto Seijas.

Ethics declarations

Conflict of interest

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that may pose as conflicts of interest in connection with the submitted article.

Ethical approval

The present study was reviewed and approved by the Ethical Committee of Hospital Quirón, Barcelona.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seijas, R., Barastegui, D., López-de-Celis, C. et al. Preoperative risk factors in hip arthroscopy. Knee Surg Sports Traumatol Arthrosc 29, 1502–1509 (2021). https://doi.org/10.1007/s00167-021-06484-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-021-06484-0

Keywords

Search

Navigation