Older patients experience worse outcomes following hip arthroscopy for FAI
LOS ANGELES — Following hip arthroscopy for femoroacetabular impingement, patients older than 45 years of age had worse outcomes compared with younger patients, according to a presenter here.
“A matched cohort of patients undergoing hip arthroscopy for femoroacetabular impingement demonstrated that patients over [the age of] 45 performed worse than younger patients, with females over 45 demonstrating the poorest outcomes,” Shane Nho, MD, said during his presentation at the Arthroscopy Association of North America Annual Meeting.
Nho and colleagues divided 150 patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) into groups by gender and age, including women younger than 30 years, women between the ages of 30 years and 45 years, women older than 45 years, men younger than 30 years, men between the ages of 30 years and 45 years, and men older than 45 years. Patient-reported outcomes were collected preoperatively and at 6 months, 1 year and 2 years, and primary outcome measures included the Hip Outcome Score – Activities of Daily Living component (HOS-ADL) and Sport-Specific Subscales (HOS-SS), modified Harris Hip Score and the VAS. The researchers also recorded revision rate and complications.
Patient-reported outcomes showed patients older than 45 years had statistically significantly inferior results compared with younger patients, according to the researchers. Although all six groups demonstrated significant improvement in HOS-ADL, HOS-SS and modified Harris Hip Scores at final follow-up, Nho said women and men older than 45 years scored lower on hip outcome scores and modified Harris Hip Score. However, the hip outcome scores and modified Harris Hip Score were higher in men older than 45 years compared with women older than 45 years. Additionally, study results showed patients older than 45 had significantly smaller joint space width.
“There were significant positive correlations between joint space width and postoperative patient reported outcome scores,” Nho said. “Multiple regression analysis was performed, and we found both age and gender were significant independent predictors of clinical outcome scores, but that joint space was not.” – by Casey Tingle
Frank R, et al. Paper #SS-35. Presented at: Arthroscopy Association of North America Annual Meeting. April 23-25, 2015; Los Angeles.
Disclosure: Nho reports he is a paid consultant for Stryker, Pivot Medical and Ossur; has stock options with Pivot Medical; received research support from Arthrex, Linvatec, Smith & Nephew, DJ Orthopaedics, Miomed, Athletico, Stryker, Pivot Medical and Allosource; and is an editorial board member for the Journal of Bone and Joint Surgery.