Revision Hip Preservation Surgery with Hip Arthroscopy: Clinical Outcomes
Authors: Domb BG, Stake CE, Lindner D, El-Bitar Y, Jackson TJ
DOI: 10.1016/j.arthro.2014.02.005
Purpose
To evaluate outcomes following revision hip arthroscopy and identify predictors of success or failure.
Methods
Retrospective study of 47 hips (43 patients) undergoing revision arthroscopy, with PROs collected pre-op and at multiple post-op intervals. Multivariate regression analyzed predictors.
Key Findings
- 66% had inadequately treated or unaddressed FAI at index surgery.
- Significant improvements in all PROs and pain scores (VAS from 7.3 to 3.9, P < .0001).
- 65% improved ≥10 points and 44% ≥20 points on the Non-Arthritic Hip Score.
- 3 patients (4 hips) converted to total hip arthroplasty.
- Positive outcome predictors: prior open surgery, cam/pincer impingement, labral reconstruction, heterotopic ossification.
Conclusion
Revision hip arthroscopy can be moderately successful, especially when underlying pathology is identified and addressed.
What Does This Mean for Providers?
- Carefully evaluate causes of failure in primary hip preservation procedures.
- Consider revision arthroscopy as a viable option, especially if residual FAI or labral defects remain.
- Use predictors identified to counsel patients on expected outcomes and risks.