What Factors Influence Long-term Survivorship After Hip Arthroscopy?
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Hip arthroscopy is an evolving procedure. One small study suggested that a low modified Harris hip score and arthritis at the time of surgery were predictors of poor prognosis.
We therefore intended to confirm those findings with a large patient cohort to (1) determine the long-term nonarthritic hip score; (2) determine survivorship; (3) identify risk factors that increase the likelihood of THA; and (4) use those factors to create a usable risk assessment algorithm.
Patients and Methods
We retrospectively reviewed 324 patients (340 hips) who underwent arthroscopy for pain and/or catching. Of these, 106 patients (111 hips or 33%) had a minimum followup of 10 years (mean, 13 years; range, 10–20 years). The average age was 39 years (± 13) with 47 men and 59 women. We recorded patient age, gender, acetabular and femoral Outerbridge grade at surgery, and the presence of a labral tear. Followup consisted of a nonarthritic hip score or the date of a subsequent THA. We determined survivorship with the end point of THA for the acetabular and femoral Outerbridge grades.
Overall survivorship among the 111 hips was 63% at 10 years. The average nonarthritic hip score for non-THA patients was 87.3 (± 12.1). Survivorship was greater for acetabular and femoral Outerbridge grades normal through II. Age at arthroscopy and Outerbridge grades independently predicted eventual THA. Gender and the presence of a labral tear did not influence long-term survivorship.
The long-term survivorship of labral tears with low-grade cartilage damage indicates hip arthroscopy is reasonable for treating labral tears.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
KeywordsCartilage Damage Loose Body Knee Arthroscopy Chondral Lesion Labral Tear
We thank David Zurakowski, PhD, Department of Orthopedic Surgery, Children’s Hospital, for his assistance with the statistical analysis.
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