Adolescents Who Underwent Revision Hip Arthroscopy Showed Comparable Magnitude of Improvement but Had Lower Clinical Benefit Rates and Higher Risk of Subsequent Surgeries Compared to a Propensity-Matched Primary Group at 2-Year Follow-Up

Adolescents Who Underwent Revision Hip Arthroscopy Showed Comparable Magnitude of Improvement but Had Lower Clinical Benefit Rates and Higher Risk of Subsequent Surgeries Compared to a Propensity-Matched Primary Group at 2-Year Follow-Up

Author(s):Maldonado DR, Schab AR, Sikligar D, Domb BG.

DOI Link: 10.1002/arj.70139

Background

Outcomes following revision hip arthroscopy in adolescents are not well defined, particularly in comparison to primary procedures. Understanding differences in clinical benefit and reoperation risk is critical for patient selection and counseling.

 Methods

This study retrospectively reviewed prospectively collected data on adolescents undergoing revision hip arthroscopy, with a minimum 2-year follow-up. A propensity-matched comparison (1:2) to a primary arthroscopy cohort was performed based on age, sex, BMI, and acetabular cartilage status. Patient-reported outcome measures (PROMs), rates of achieving clinically meaningful thresholds, and secondary surgeries were analyzed.

 Key Findings

Both primary and revision groups demonstrated significant improvement across all PROMs (mHHS, NAHS, HOS-SSS, iHOT, VAS) (P < .01).

Revision patients had significantly lower preoperative and postoperative PROM scores compared to the primary group (P < .01).

The magnitude of improvement (delta) was similar between groups.

Revision patients achieved clinically meaningful outcomes at lower rates.

Revision hips had higher rates of secondary arthroscopy (21.6% vs 5.4%; P < .05).

Revision patients were 4.83 times more likely to require an additional rerevision procedure.

 Conclusion

Although adolescents undergoing revision hip arthroscopy experience significant improvements comparable in magnitude to primary cases, they achieve clinically meaningful outcomes less frequently and have a substantially higher risk of subsequent surgery.

 What Does This Mean for Providers?

Revision hip arthroscopy in adolescents can yield meaningful improvement; however, expectations should be tempered given lower rates of achieving clinical benefit thresholds and increased reoperation risk. Careful patient selection, thorough evaluation of residual pathology, and precise surgical correction are critical. These findings should inform preoperative counseling and highlight the importance of optimizing primary surgical outcomes to reduce the need for revision.