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Hip Arthroscopy in the Setting of Hip Osteoarthritis: Systematic Review of Outcomes and Progression to Hip Arthroplasty

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Clinical Orthopaedics and Related Research®

Abstract

Background

Hip arthroscopy is now commonly used to treat hip pain and pathology, including osteoarthritis (OA). Despite this, little is known about the effect of hip arthroscopy on outcomes of pain and function and progression to total hip arthroplasty (THA) in hip OA.

Questions/purposes

This systematic review aimed to (1) determine pain and function outcomes after hip arthroscopy in people with hip OA; (2) compare the outcome after hip arthroscopy between people with and without hip OA; and (3) report the likelihood of progression to THA in patients with hip OA after hip arthroscopy.

Methods

This review was conducted in accordance with the PRISMA statement. The Downs and Black checklist was used for quality appraisal. Studies scoring positively on at least 50% of items were included in final analyses. Standardized mean differences (SMDs) were calculated where possible or study conclusions are presented.

Results

Twenty-two studies were included in the final analyses. Methodological quality and followup time varied widely. Moderate to large SMDs were reported for people with and without hip OA; however, the positive effects of the intervention were smaller for people with hip OA. Greater severity of hip OA and older age each predicted more rapid progression to THA.

Conclusions

Patients with hip OA report positive outcomes from hip arthroscopy, although observed positive effects may be inflated as a result of methodological limitations of the included studies. Patients with hip OA had inferior results compared with those who did not. Chondropathy severity and patient age were associated with a higher risk and more rapid progression to THA. High-quality comparative studies are required to confirm the effects of hip arthroscopy on symptoms and structural change in people with hip OA.

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Author information

Authors and Affiliations

  1. School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia

    Joanne L. Kemp PT, PhD, David MacDonald PT, PhD, Anna L. Hatton PT, PhD & Kay M. Crossley PT, PhD

  2. Australian Centre for Research Into Injury in Sport and Its Prevention, Federation University, SMB Campus, P.O. Box 663, Ballarat, VIC, 3350, Australia

    Joanne L. Kemp PT, PhD

  3. Melbourne School of Engineering, University of Melbourne, Melbourne, VIC, Australia

    Natalie J. Collins PT, PhD

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  1. Joanne L. Kemp PT, PhD
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  2. David MacDonald PT, PhD
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Correspondence to Joanne L. Kemp PT, PhD.

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Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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This work was performed at the University of Queensland, Brisbane, Australia.

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Kemp, J.L., MacDonald, D., Collins, N.J. et al. Hip Arthroscopy in the Setting of Hip Osteoarthritis: Systematic Review of Outcomes and Progression to Hip Arthroplasty. Clin Orthop Relat Res 473, 1055–1073 (2015). https://doi.org/10.1007/s11999-014-3943-9

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