Editorial Commentary: Primary Treatment of Hip Labral, Osseous, Chondral, Capsular, and Extra-Articular Pathology Is Essential: Outcomes Following Revision Are Less Predictable
Authors: Kuhns BD, Domb BG
Journal: Arthroscopy, July 2024
DOI: 10.1016/j.arthro.2024.02.007
Objective
To emphasize the importance of comprehensive and high-quality initial hip arthroscopy to optimize outcomes and minimize the need for revision surgery.
Key Findings
- Early labral reconstruction is critical when repair is not feasible to maximize function.
- Primary surgeries result in better clinical outcomes compared to revisions.
- Addressing all pathologies—osseous, chondral, capsular, and extra-articular—in the initial surgery improves long-term success.
Conclusion
Achieving comprehensive treatment in the primary hip arthroscopy is essential for durable success and reducing unpredictable revision outcomes.
What Does This Mean for Providers?
- Prioritize thorough evaluation and management of all hip pathologies during the initial procedure.
- Consider early labral reconstruction if repair is not possible to improve functional outcomes.
- Understand that revision surgeries carry less predictable results; strive to “get it right the first time.”
- Educate patients on the importance of comprehensive primary surgery to optimize prognosis.