How much arthritis is too much for hip arthroscopy: a systematic review

How much arthritis is too much for hip arthroscopy: a systematic review

Authors

Domb BG, Gui C, Lodhia P
DOI: 10.1016/j.arthro.2014.11.008

Purpose

To determine the extent of preoperative osteoarthritis (OA) that predicts poor outcomes after hip arthroscopy by reviewing existing literature.

Methods

Systematic review of 15 studies including 2051 hips with at least some degree of arthritic changes. Outcomes and rates of conversion to total hip arthroplasty (THA) or surface replacement were analyzed relative to the degree of preoperative OA.

Key Findings

• Patients with Tönnis grade ≥1 or joint space ≤2 mm had lower likelihood of benefiting from hip arthroscopy.
• These patients were more likely to require conversion to THA or surface replacement.
• Outcome scores were lower postoperatively in patients with arthritis compared to nonarthritic patients.

Conclusion

While a precise cutoff for “too much arthritis” is not defined, mild arthritis (Tönnis grade ≥1 or joint space ≤2 mm) reduces the benefit of hip arthroscopy and increases the risk of needing further surgery.

What This Means for Patients

Patients with significant arthritis should be counseled about the higher risk of poor outcomes and potential need for hip replacement after arthroscopy.