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
Determine the degree of preoperative osteoarthritis (OA) that predicts poorer outcomes after hip arthroscopy.
Methods
Systematic review of 15 studies (2051 hips) analyzing outcomes and rates of conversion to total hip arthroplasty (THA) relative to OA severity.
Key Findings
- Patients with Tönnis grade ≥1 or joint space ≤2 mm show less benefit from hip arthroscopy.
- These patients have higher rates of conversion to THA or surface replacement.
- Post-op outcomes are generally worse in arthritic hips compared to non-arthritic hips.
Conclusion
Mild arthritis reduces arthroscopy benefits and increases subsequent surgery risk; no exact cutoff but Tönnis ≥1 or joint space ≤2 mm are warning signs.
What Does This Mean for Providers?
- Screen carefully for OA severity preoperatively (radiographs for Tönnis grade, joint space width).
- Counsel patients with mild arthritis about limited arthroscopy benefits and higher conversion risk.
- Consider alternative treatments or prepare for possible hip replacement in these cases.