Revision Hip Preservation Surgery with Hip Arthroscopy: Clinical Outcomes
Authors
Domb BG, Stake CE, Lindner D, El-Bitar Y, Jackson TJ
https://doi.org/10.1016/j.arthro.2014.02.005
Purpose
To evaluate clinical outcomes following revision hip preservation surgery using hip arthroscopy and to identify predictors of success and failure.
Methods
This retrospective study included patients who underwent revision hip arthroscopy from April 2008 to December 2010, including those with prior open surgery. Patient-reported outcomes (PROs) were collected preoperatively and at several postoperative intervals (3 months, 1, 2, and 3 years). Multivariate regression was used to identify predictors of PRO improvement.
Key Findings
- 47 hips (43 patients) were analyzed with a mean follow-up of 29 months.
- 66% of hips had previously unaddressed or inadequately treated femoroacetabular impingement (FAI).
- Significant improvement in all PROs and pain scores (VAS from 7.3 to 3.9, P < .0001).
- 65% improved by ≥10 points and 44% by ≥20 points on the Non-Arthritic Hip Score.
- 3 patients (4 hips) required conversion to total hip arthroplasty.
- Positive predictors: prior open surgery, cam/pincer impingement, segmental labral defects treated with labral reconstruction, and heterotopic ossification.
Conclusion
Revision hip arthroscopy offers moderate success and remains a viable option after failed primary hip preservation. Certain preoperative findings predict better outcomes.
What This Means for Patients
Patients with failed initial hip surgeries may still benefit from revision arthroscopy, particularly when specific underlying issues are correctly identified and addressed.