Abstract
Background
Femoro-acetabular impingement (FAI) is known as a predisposing factor in the development of osteoarthritis of the hip. In order to treat this condition, hip arthroscopy is considered as the gold standard in recent years. The number of performed hip arthroscopies has risen immensely. However, a number of patients with poor outcome after hip arthroscopy will require further surgical intervention, sometimes even conversion into THR (total hip replacement). The purpose of this study was to analyze whether outcomes of THR are affected by prior hip arthroscopy in these patients.
Methods
Patients who underwent a THR following an ipsilateral hip arthroscopy were matched to a control group of THR patients with no history of prior ipsilateral hip surgery. Matching criteria were age, sex, body mass index, implants used, and surgical approach. Modified Harris Hip Score, surgical time, presence of heterotopic ossification, and post-operative complication were prospectively compared at a minimum two year follow-up.
Results
Thirty-three THR after hip arthroscopy patients were successfully matched to control patients. There was no significant difference in mHHS between both groups (FAI treatment group 92.8 vs. control group 93.8, p = 0.07). However, FAI treatment group showed a lower mHHS score pre-operatively (48 vs. 60, p = 0.002). There was no significant difference in surgical time and post-operative complication rate. No heterotopic ossification could be found.
Conclusion
A prior hip arthroscopy has no affect to clinical outcomes of subsequent THR.
Similar content being viewed by others
Change history
08 May 2019
The original version of this article was revised: The first name and last name of the authors have been interchanged.
References
Ganz R, Leunig M, Leunig-Ganz K et al (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466(2):264–272. https://doi.org/10.1007/s11999-007-0060-z
Ganz R, Parvizi J, Beck M et al (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res (417):112–120. https://doi.org/10.1097/01.blo.0000096804.78689.c2
Beck M, Kalhor M, Leunig M et al (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg (Br) 87(7):1012–1018. https://doi.org/10.1302/0301-620X.87B7.15203
Kaya M, Suzuki T, Emori M et al (2016) Hip morphology influences the pattern of articular cartilage damage. Knee Surg Sports Traumatol Arthrosc 24(6):2016–2023. https://doi.org/10.1007/s00167-014-3297-6
Magrill ACL, Nakano N, Khanduja V (2017) Historical review of arthroscopic surgery of the hip. Int Orthop 41(10):1983–1994. https://doi.org/10.1007/s00264-017-3454-x
Maradit Kremers H, Schilz SR, van Houten HK et al (2017) Trends in utilization and outcomes of hip arthroscopy in the United States between 2005 and 2013. J Arthroplast 32(3):750–755. https://doi.org/10.1016/j.arth.2016.09.004
Bozic KJ, Chan V, Valone FH et al (2013) Trends in hip arthroscopy utilization in the United States. J Arthroplast 28(8 Suppl):140–143. https://doi.org/10.1016/j.arth.2013.02.039
Montgomery SR, Ngo SS, Hobson T et al (2013) Trends and demographics in hip arthroscopy in the United States. Arthroscopy 29(4):661–665. https://doi.org/10.1016/j.arthro.2012.11.005
Nakano N, Gohal C, Duong A et al (2018) Outcomes of cartilage repair techniques for chondral injury in the hip-a systematic review. Int Orthop 42(10):2309–2322. https://doi.org/10.1007/s00264-018-3862-6
Sariali E, Vandenbulcke F (2018) Clinical outcomes following arthroscopic treatment of femoro-acetabular impingement using a minimal traction approach and an initial capsulotomy. Minimum two year follow-up. Int Orthop 42(11):2549–2554. https://doi.org/10.1007/s00264-018-3904-0
Rego PA, Mascarenhas V, Oliveira FS et al (2018) Arthroscopic versus open treatment of cam-type femoro-acetabular impingement: retrospective cohort clinical study. Int Orthop 42(4):791–797. https://doi.org/10.1007/s00264-017-3735-4
Kautzner J, Zeman P, Stancak A et al (2018) Hip arthroscopy learning curve: a prospective single-surgeon study. Int Orthop 42(4):777–782. https://doi.org/10.1007/s00264-017-3666-0
Lund B, Mygind-Klavsen B, Grønbech Nielsen T et al (2017) Danish Hip Arthroscopy Registry (DHAR): the outcome of patients with femoroacetabular impingement (FAI). J Hip Preserv Surg 4(2):170–177. https://doi.org/10.1093/jhps/hnx009
Nwachukwu BU, Chang B, Kahlenberg CA et al (2017) Arthroscopic treatment of femoroacetabular impingement in adolescents provides clinically significant outcome improvement. Arthroscopy. https://doi.org/10.1016/j.arthro.2017.04.008
Spencer-Gardner L, Dissanayake R, Kalanie A et al (2017) Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients. J Hip Preserv Surg 4(1):39–44. https://doi.org/10.1093/jhps/hnw051
Daivajna S, Bajwa A, Villar R (2015) Outcome of arthroscopy in patients with advanced osteoarthritis of the hip. PLoS One 10(1):e0113970. https://doi.org/10.1371/journal.pone.0113970
McCarthy JC, Jarrett BT, Ojeifo O et al (2011) What factors influence long-term survivorship after hip arthroscopy? Clin Orthop Relat Res 469(2):362–371. https://doi.org/10.1007/s11999-010-1559-2
Piedade SR, Pinaroli A, Servien E et al (2009) Is previous knee arthroscopy related to worse results in primary total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 17(4):328–333. https://doi.org/10.1007/s00167-008-0669-9
Piedade SR, Pinaroli A, Servien E et al (2013) TKA outcomes after prior bone and soft tissue knee surgery. Knee Surg Sports Traumatol Arthrosc 21(12):2737–2743. https://doi.org/10.1007/s00167-012-2139-7
Spencer-Gardner LS, Camp CL, Martin JR et al (2016) Does prior surgery for femoroacetabular impingement compromise hip arthroplasty outcomes? J Arthroplast 31(9):1899–1903. https://doi.org/10.1016/j.arth.2016.02.036
Haughom BD, Plummer DR, Hellman MD et al (2016) Does hip arthroscopy affect the outcomes of a subsequent total hip arthroplasty? J Arthroplast 31(7):1516–1518. https://doi.org/10.1016/j.arth.2016.01.008
Perets I, Mansor Y, Mu BH et al (2017) Prior arthroscopy leads to inferior outcomes in total hip arthroplasty: a match-controlled study. J Arthroplast. https://doi.org/10.1016/j.arth.2017.06.050
Zingg PO, Schallberger A, Rüdiger HA et al (2012) Does previous hip arthroscopy negatively influence the short term clinical result of total hip replacement? Arch Orthop Trauma Surg 132(3):299–303. https://doi.org/10.1007/s00402-011-1352-z
Nam D, Maher P, Nath T et al (2014) Does a prior hip arthroscopy affect clinical outcomes in metal-on-metal hip resurfacing arthroplasty? Am J Orthop 43(11):E255–E260
Brooker AF, Bowerman JW, Robinson RA et al (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55(8):1629–1632
Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755
Byrd JW, Jones KS (2000) Prospective analysis of hip arthroscopy with 2-year follow-up. Arthroscopy 16(6):578–587. https://doi.org/10.1053/jars.2000.7683
Söderman P (2000) On the validity of the results from the Swedish National Total Hip Arthroplasty register. Acta Orthop Scand Suppl 71(296):1–33
Kemp JL, Collins NJ, Makdissi M et al (2012) Hip arthroscopy for intra-articular pathology: a systematic review of outcomes with and without femoral osteoplasty. Br J Sports Med 46(9):632–643. https://doi.org/10.1136/bjsports-2011-090428
Aprato A, Jayasekera N, Villar RN (2012) Does the modified Harris Hip Score reflect patient satisfaction after hip arthroscopy? Am J Sports Med 40(11):2557–2560. https://doi.org/10.1177/0363546512460650
Domb BG, Chaharbakhshi EO, Rybalko D et al (2017) Outcomes of hip arthroscopic surgery in patients with Tönnis grade 1 osteoarthritis at a minimum 5-year follow-up: a matched-pair comparison with a Tönnis grade 0 control group. Am J Sports Med 45(10):2294–2302. https://doi.org/10.1177/0363546517706957
Bedi A, Zbeda RM, Bueno VF et al (2012) The incidence of heterotopic ossification after hip arthroscopy. Am J Sports Med 40(4):854–863. https://doi.org/10.1177/0363546511434285
Neal B, Gray H, MacMahon S et al (2002) Incidence of heterotopic bone formation after major hip surgery. ANZ J Surg 72(11):808–821
Charles R, LaTulip S, Goulet JA et al (2017) Previous arthroscopic repair of femoro-acetabular impingement does not affect outcomes of total hip arthroplasty. Int Orthop 41(6):1125–1129. https://doi.org/10.1007/s00264-016-3330-0
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that there is no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The original version of this article was revised: The first name and last name of the authors have been interchanged.
Rights and permissions
About this article
Cite this article
Hoeltzermann, M., Sobau, C., Miehlke, W. et al. Prior arthroscopic treatment for femoro-acetabular impingement does not compromise hip arthroplasty outcomes: a matched-controlled study with minimum two-year follow-up. International Orthopaedics (SICOT) 43, 1591–1596 (2019). https://doi.org/10.1007/s00264-019-04330-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-019-04330-0