Abstract
Purpose
Hip arthroscopy has traditionally been viewed as a hip preservation procedure performed in patients with native joint pathology. However, as the list of indications for arthroscopic hip intervention grows, further advances are expanding its use. The purpose of this systematic review was to examine existing evidence supporting the use of hip arthroscopy in the setting of hip arthroplasty.
Methods
Using predetermined inclusion criteria, EMBASE, MEDLINE and PubMed were searched for articles addressing arthroscopic hip surgery performed in hips containing joint replacement arthroplasties. Inclusion criteria limited our search to human and English language studies addressing articles where clear surgical indications are described. Article screening was conducted in duplicate.
Results
Seven-hundred and forty-three studies were retrieved before duplicate screening, and 18 satisfied inclusion criteria. Eleven case series, six case reports and one prospective cohort study are included. In total, 171 patients underwent hip arthroscopy following previous arthroplasty. Indications for arthroscopy included iliopsoas tendinopathy (35.8 %), symptomatic hips with no clear diagnosis despite extensive investigation (24.6 %), periprosthetic infection (6.4 %) and intra-articular loose bodies (3.5 %). Almost all patients who underwent hip arthroscopy experienced positive outcomes from the procedure.
Conclusion
Hip arthroscopy after hip arthroplasty is supported by our systematic review for a variety of indications. Hip arthroscopy can be a safe and effective method of treating hip arthroplasty patients with iliopsoas tendinopathy. Hip arthroscopy also has utility in patients with symptomatic hip arthroplasty despite exhaustion of other diagnostic avenues.
Level of evidence
A systematic review of level IV studies.
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Acknowledgements
This research was supported/partially supported by Dr. Hany Bedair. The authors would like to thank Dr. Bedair for his advice and comments that greatly improved the manuscript.
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Appendix
Appendix
Search strategy
PubMed | MEDLINE | EMBASE |
---|---|---|
Exp hip arthroscopy | Exp arthroscopy | Exp hip arthroscopy |
Exp hip arthroplasty | Exp arthroplasty, replacement, hip | Exp hip arthroplasty |
Exp hip prosthesis | Exp hip prosthesis | Exp total hip prosthesis |
1 and 2 | 1 and 2 | 1 and 2 |
1 and 3 | 1 and 3 | 1 and 3 |
1 and 2 and 3 | 1 and 2 and 3 | 1 and 2 and 3 |
Limit 4, 5 and 6 to English language and human studies | Limit 4, 5 and 6 to English language and human studies | Limit 4, 5 and 6 to English language and human studies |
515 articles (236 after dupl) | 82 articles (0 after dupl) | 146 articles (82 after dupl) |
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Heaven, S., de SA, D., Simunovic, N. et al. Hip arthroscopy in the setting of hip arthroplasty. Knee Surg Sports Traumatol Arthrosc 24, 287–294 (2016). https://doi.org/10.1007/s00167-014-3379-5
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DOI: https://doi.org/10.1007/s00167-014-3379-5