Original Article
Predictors of Hip Arthroscopy Outcomes for Labral Tears at Minimum 2-Year Follow-up: The Influence of Age and Arthritis

https://doi.org/10.1016/j.arthro.2012.04.059Get rights and content

Purpose

The purpose of this study was to perform a retrospective case-control outcome analysis at a minimum 2-year follow-up using a validated hip arthroscopy outcome measure to determine whether arthritis or age is predictive of outcomes after hip arthroscopy for labral pathology.

Methods

We identified 176 consecutive patients undergoing hip arthroscopy for labral tears performed between 2001 and 2009 to complete the Modified Harris Hip Score (MHHS) and Hip Outcome Score questionnaires. Patients who underwent additional surgeries or reported an MHHS of less than 80 were compared with the control group of patients who achieved good to excellent surgical results on the MHHS (>80) to calculate odds ratios with 95% confidence intervals by use of the independent variables of patient age of 40 years or older and age below 40 years and the presence of grade 4 Outerbridge changes found at arthroscopy.

Results

Of 176 patients, 125 (71%) were contacted: 27 patients had undergone additional surgery in the follow-up period, and 98 completed questionnaires. The mean patient age at surgery was 40.9 years (range, 17.3 to 62.8 years) at a mean follow-up of 4.3 years (range, 2 to 10.4 years). Of 98 respondents, 71 (72%) obtained a good to excellent surgical outcome, with 84% reporting satisfaction. The presence of osteoarthritic changes at the time of arthroscopy was predictive of worse outcome scores compared with the nonarthritic cohort (odds ratio, 2.5; 95% confidence interval, 1.2 to 5.3; P = .02). Youth (age <40 years) is predictive of good to excellent results (odds ratio, 7; 95% confidence interval, 2.9 to 16.9; P < .0001).

Conclusions

Of the 98 patients who completed the questionnaires in this study, 71 (72%) obtained good to excellent outcome scores. Overall satisfaction among patients undergoing hip arthroscopy was high (84%). Patients aged younger than 40 years did better than older patients, and arthroscopically identified arthritis was predictive of worse surgical outcomes.

Level of Evidence

Level III, case-control study.

Section snippets

Study Design

After approval by the internal review board at a tertiary care hospital, patient records and surgical reports from July 2001 through July 2009 were retrospectively reviewed to identify patients who underwent hip arthroscopy for labral pathology. All surgeries were performed by a single surgeon who is fellowship trained in both sports medicine and total joint arthroplasty. Eligible patients were identified by a query of the electronic billing records by use of International Classification of

Demographics

We identified 200 patients by query, of whom 24 did not meet the inclusion criteria (Fig 1). Among the 176 eligible patients identified, the mean patient age at surgery was 40.9 years (range, 17.3 to 62.8 years) at a mean follow-up of 4.3 years (range, 2 to 10.4 years). There were 104 female patients (59%), 87 hips (51%) were noted to have femoroacetabular impingement (FAI), and labral pathology developed in 41 hips (23%) as a result of trauma (Table 1). There were no significant complications

Discussion

To our knowledge, this study is the largest case series in the literature reporting on the surgical results of patients undergoing hip arthroscopy with a minimum of 2 years' follow-up using a validated outcomes score. Overall, we found that surgical results after hip arthroscopy for labral pathology are primarily good to excellent across numerous outcome assessments, with very strong agreement among outcome measure tools. Furthermore, we report high subjective patient satisfaction with hip

Conclusions

In our large retrospective case series using a validated outcome, we found that of the 98 patients who completed the questionnaires, 71 (72%) obtained a good to excellent MHHS. Overall satisfaction among these 98 patients was high (84%). Patients aged younger than 40 years did better than older patients, and arthroscopically identified arthritis was predictive of surgical outcomes.

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    The authors report that they have no conflicts of interest in the authorship and publication of this article.

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