Propensity-Matched Patients Undergoing Revision Hip Arthroscopy Older Than the Age of 40 Years Had Greater Risk of Conversion to Total Hip Arthroplasty Compared With Their Primary Counterparts
Authors: Maldonado DR, Diulus SC, Lee MS, Owens JS, Jimenez AE, Perez-Padilla PA, Domb BG
Journal: Arthroscopy, January 2023
DOI: 10.1016/j.arthro.2022.06.014
Background
This study compares outcomes and risk of conversion to total hip arthroplasty (THA) in patients aged 40 or older undergoing revision hip arthroscopy versus primary hip arthroscopy.
Methods
- 89 hips from patients aged ≥40 undergoing revision hip arthroscopy were studied with at least 2 years of follow-up.
- Propensity matching was performed against primary hip arthroscopy patients based on age, sex, BMI, and labrum damage.
Key Findings
- Both groups demonstrated significant improvements in patient-reported outcomes (PROs).
- Revision arthroscopy patients had a 2.63-fold increased risk of conversion to THA compared with the primary group.
Conclusions
Revision hip arthroscopy in patients over 40 improves symptoms but carries a significantly higher risk for subsequent hip replacement than primary arthroscopy.
What Does This Mean for Providers
- Counsel patients ≥40 undergoing revision hip arthroscopy about the elevated risk of eventual conversion to THA relative to primary surgery.
- Consider patient age and prior surgery status carefully when recommending revision procedures.
- Optimize patient selection and set realistic expectations regarding longevity of revision arthroscopy benefits.
- Plan closer follow-up and monitoring in this higher-risk group.