Original Articles
Prospective analysis of hip arthroscopy with 2-year follow-up*

https://doi.org/10.1053/jars.2000.7683Get rights and content

Abstract

Purpose: Numerous indications, but little outcome data, have been reported for hip arthroscopy. The purpose of this prospective study is to report the 2-year results of hip arthroscopy performed on a consecutive series of patients for a variety of disorders. Type of Study: Case series. Materials and Methods: There were 38 procedures performed on 35 patients who have achieved 2-year follow-up. All patients were assessed with a modified Harris hip score (pain and function) preoperatively and postoperatively at 1, 3, 6, 12, and 24 months or until a subsequent procedure was performed. Variables studied included age, sex, diagnosis, duration of symptoms, onset of symptoms, center-edge angle, Workers' Compensation, and pending litigation. Results: Follow-up was obtained on all patients. The median score improved from 57 to 85 points. This included 10 cases (9 patients) who underwent a subsequent procedure at an average of 10 months (6 total hip arthroplasty, 1 core decompression, 3 second arthroscopy) with an index score of 54 compared with 52 at the time of the second procedure. The median improvement for the following diagnoses was: loose body (34), labral lesion (27), synovitis (26), chondral injury (18), arthritis (14), and avascular necrosis (−11). Of the variables studied, the most statistically significant finding was that older men with longer duration of symptoms did worse. Two complications occurred in 1 patient: partial neuropraxia of the lateral femoral cutaneous nerve and focal myositis ossificans along the anterior portal tract. Conclusions: Hip arthroscopy can be performed for a variety of conditions (except end-stage avascular necrosis) with reasonable expectations of success and an acceptable complication rate. This is the first report to quantitate the results of hip arthroscopy for a heterogeneous population.

Arthroscopy: The Journal of Arthroscopic and Related surgery, Vol 16, No 6 (September), 2000: pp 578–587

Section snippets

Materials and methods

In March 1993, the authors began tracking all patients undergoing hip arthroscopy. As of December 1997, data on 121 consecutive cases had been gathered. All procedures were performed supine using distraction on a modified fracture table as previously reported by the senior author.3, 4, 8, 9, 10 The substance of this study includes those patients who have achieved 2-year follow-up and encompasses 38 procedures performed on 35 patients.

All patients were assessed using a modified Harris hip score

Results

Follow-up was achieved in 100% of patients (38 cases in 35 patients). Overall, the median score improved 28 points from a preoperative value of 57 to 85 postoperatively. These results included 10 cases (9 patients) who underwent a subsequent procedure at an average of 10 months. For this group of 10 cases, the median preoperative score was 54 compared with 52 at the time of the second procedure. Six patients underwent total hip arthroplasty: 2 for osteoarthritis, 1 for inflammatory arthritis, 1

Discussion

For group analysis purposes, use of the median score was selected because it most accurately reflected the patient groups, incorporating those patients who dropped out during the 24-month period. To delete these cases from the study at the time they dropped out would have artificially made the subsequent results appear better over the period of the study. Thus, by assuming that the result of a patient in the drop-out group would be lower than the lowest score for those who completed the study,

Conclusions

Arthroscopic surgery of the hip is a well-established technique. This report substantiates the benefits of this procedure for a variety of disorders. Over time, continuation of the model proposed here will allow us to better define results and, consequently, the indications for this technique. It should be noted that, although arthroscopy may have a role in addressing coexistent pathology associated with AVN, as a palliative procedure for end-stage disease, it is uniformly unsuccessful.

The

Acknowledgements

Acknowledgment: The authors acknowledge the invaluable assistance of George Reed in the statistical analysis and Sharon Simmons in preparation of the manuscript.

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*

Address correspondence and reprint requests to J. W. Thomas Byrd, M.D., Southern Sports Medicine & Orthopaedic Center, 2021 Church St, Second Floor, Nashville, TN 37203, U.S.A.

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Copyright © 2000 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.