Indications and Outcomes of Secondary Hip Procedures After Failed Hip Arthroscopy: A Systematic Review
Authors: Shapira J, Kyin C, Go C, Rosinsky PJ, Maldonado DR, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2020.02.028
Background
This systematic review evaluates the indications and outcomes of secondary procedures—including revision arthroscopy, periacetabular osteotomy (PAO), and total hip arthroplasty (THA)—performed after failed primary hip arthroscopy.
Methods
Eighteen studies involving patients who underwent secondary surgeries after failed hip arthroscopy were analyzed. Outcomes and patient-reported measures were compared with those of primary surgery groups.
Key Findings
- Revision hip arthroscopy generally resulted in favorable outcomes but slightly inferior to primary arthroscopy results.
- Outcomes after secondary PAO or THA varied; some showed comparable results to primary surgeries while others did not.
Conclusions
Secondary hip procedures can be effective in managing failed primary arthroscopy cases, but overall outcomes may not match those of initial surgeries. The type of secondary procedure significantly influences the results.
What Does This Mean for Providers?
Providers should counsel patients on realistic expectations regarding secondary procedures after failed hip arthroscopy, emphasizing that outcomes may be less favorable compared to primary surgery. Procedure selection should be individualized based on patient pathology and prior surgical history.