Identifying the Most Successful Procedures in Hip Arthroscopy
Authors: Hammarstedt JE, Laseter JR, Gupta A, Christoforetti JJ, Lall AC, Domb BG
DOI: 10.3928/01477447-20200129-01
Background
While hip arthroscopy for labral tears is increasingly common, the long-term success of specific procedures and their impact on future hip surgeries remains unclear.
Methods
Analysis of 1,118 patients treated with hip arthroscopy from 2008 to 2015 evaluated the association between different surgical procedures and subsequent revision arthroscopy or total hip replacement.
Key Findings
- 9.8% of patients progressed to total hip arthroplasty within a few years post-arthroscopy.
- Procedures such as labral debridement and notchplasty were associated with increased risk of hip replacement.
- Trochanteric bursectomy was linked to better hip survival rates.
- Revision surgery risk was higher with workers' compensation status, capsular repair, and femoral head microfracture.
Conclusions
Certain arthroscopic procedures may increase the likelihood of future hip replacement or revision surgery, highlighting the need to tailor surgical techniques carefully.
What Does This Mean for Providers?
Careful selection of arthroscopic procedures is critical for optimizing long-term outcomes. Avoiding labral debridement and notchplasty when possible may reduce the risk of early total hip arthroplasty. Consider trochanteric bursectomy as a procedure with better survival benefits. Additionally, be vigilant in managing patients with risk factors such as workers' compensation claims or those requiring microfracture. These insights should guide preoperative planning and patient counseling regarding prognosis and expectations.