2019 ISAKOS Biennial Congress ePoster #656
Hip Arthroscopy in Patients Aged 50 Years or Older: Minimum Five-Year Outcomes and Risk Factors Associated with Conversion to Total Hip Arthroplasty
Itay Perets, MD, Jerusalem ISRAEL
Edwin O. Chaharbakhshi, BS, Chicago, IL UNITED STATES
Brian H. Mu, BA, Chicago, IL UNITED STATES
Lyall J. Ashberg, MD, Atlantis, FL UNITED STATES
Muriel Battaglia, BA, Chicago, IL UNITED STATES
Leslie C. Yuen, BA, Hanover, NH UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
American Hip Institute, Chicago, IL, UNITED STATES
FDA Status Not Applicable
Hip arthroscopy for the treatment of labral tears and FAI in patients aged = 50 years old is safe and demonstrates significant improvements at a minimum of five-years postoperatively.
To report minimum five-year outcomes and risk factors for conversion to total hip arthroplasty (THA) in patients aged >= 50 years undergoing hip arthroscopy to treat labral tears and femoroacetabular impingement (FAI).
Data were prospectively collected on patients that underwent hip arthroscopy to treat labral tears and FAI between February 2008 and January 2012. The inclusion criteria were age 50 years or older at surgery, arthroscopic treatment for both labral tears and FAI, and preoperative patient-reported outcome (PRO) scores including modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score - Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS). The exclusion criteria were Tönnis grade > 1, previous hip conditions or surgeries.
Of 103 eligible cases, 94 hips (91.3%) had minimum five-year follow-up at a mean of 70.1 months (range: 60.0, 95.1). All PROs and VAS demonstrated significant improvements at latest follow-up (p=0.0001). Mean patient satisfaction was 8.4. All mean scores demonstrated durability from 2 years to latest follow-up and NAHS (0.009), HOS-SSS (p = 0.02), and VAS (p = 0.04) continued to significantly improve. Five cases (5.3%) required secondary arthroscopy. Twenty-six cases (27.7%) required THA. Compared to survivors, the subgroup requiring THA demonstrated higher BMIs (p=0.01), a higher proportion of Tönnis grade 1 (p=0.0012), larger alpha angles (p=0.02), smaller LCEAs (p=0.02), a higher proportion of acetabular Outerbridge grade >= 2 (p=0.05), and a higher proportion of femoral head Outerbridge grade >= 2 (p=0.0001).
Hip arthroscopy for the treatment of labral tears and FAI in patients aged = 50 years old is safe and demonstrates significant improvements at a minimum of five-years postoperatively. In light of the THA conversion rate and risk factors for endpoint surgery, patient selection in this age group should be rigorous.
Level of Evidence: IV