Patients who underwent primary hip arthroscopy experienced greater improvement in patient-reported outcome scores at 2-year follow-up compared with patients who underwent revision arthroscopy, according to recently presented data.
“The relative risk of total hip arthroplasty was often two-times [greater] after revision arthroscopy compared to primary,” Parth Lodhia, MD, FRCSC, of RebalanceMD, said. “There was a significant improvement in all patient-reported outcome scores at 2 years for primary and for revision arthroscopies and, finally, primary arthroscopy patients showed greater patient-reported outcome scores compared to revision.”
Primary vs revision hip arthroscopy
Lodhia and Benjamin G. Domb, MD, sports medicine orthopedic surgeon and founder of the American Hip Institute, identified 1,038 hips in 872 patients who underwent a primary or revision hip arthroscopy between February 2008 and June 2012 and had a minimum follow-up of 2 years. Researchers collected modified Harris Hip scores, nonarthritic hip score, VAS score, activities of daily living and the sport-specific subscales of the hip outcome score preoperatively and at 3 months, 1 year and 2 years postoperatively.
Results showed significantly superior outcomes in both groups at 2 years postoperatively. However, Lodhia noted patients who underwent primary arthroscopy had significantly improved outcomes at all time points vs. the revision arthroscopy group. Researchers also found a significantly higher incremental increase in the improvement of patient-reported outcome scores in the primary arthroscopy group vs. the revision hip arthroscopy group at all time points.
“We went on to look at cumulative risk after primary arthroscopy of either having a revision arthroscopy or having a total hip arthroscopy,” Lodhia said at the Arthroscopy Association of North America Annual Meeting. “When we looked at this at the 24-month time point, we found a cumulative risk of 2.8% for conversion to total hip replacement and 6% of undergoing secondary hip arthroscopy.”
One of the goals of this study was to refine indications for surgery to aid surgeons with appropriate patient selection, Domb said. He noted 5-year follow-up data is being evaluated and research utilizing a logistic aggression model will help “evaluate the predictive factors of favorable outcomes after hip arthroscopy.”
“I hope this study will be a meaningful contribution as we aim to create an algorithm for patient selection and indications for the surgeon. This algorithm may be used to calculate a patient’s approximate likelihood of success and risk failure after hip arthroscopy and to advise patients accordingly,” Domb said. – by Casey Tingle
- Lodhia P, et al. Paper #SS-31. Presented at: Arthroscopy Association of North America Annual Meeting; April 14-16, 2016; Boston.
- For more information:
- Benjamin G. Domb, MD, can be reached at American Hip Institute and Hinsdale Orthopedics, 1010 Executive Ct., #250, Westmont, IL 60559; email: email@example.com.
- Parth Lodhia, MD, can be reached at RebalanceMD, 104-3551 Blanshard St., Victoria, British Columbia V8Z 0B9, Canada; email: firstname.lastname@example.org.
Disclosures: Domb and Lodhia report no relevant financial disclosures.