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Archives of Orthopaedic and Trauma Surgery

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01-01-2019 | Orthopaedic Surgery

Clinical and radiological outcome at mean follow-up of 11 years after hip arthroscopy

Authors: Martin Olach, Pascal Gerhard, Karlmeinrad Giesinger, Christoph Lampert, Johannes B. Erhardt

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2019

Abstract

Introduction

The use of hip arthroscopy (HA) has substantially increased over the last decade. However, while the benefits of HA after 1 year in patients with femoroacetabular impingement (FAI) are well documented, long-term data on the progression of osteoarthritis (OA) or patient-reported outcomes (PROMs) are lacking.

Objectives

To evaluate long-term clinical and radiological outcomes after HA.

Materials and methods

Preoperative clinical records, operative notes, and radiographs from all patients who underwent HA at our hospital between 1998 and 2006 were reviewed. Exclusion criteria were previous hip surgery or diagnostic HA. Primary endpoints were subsequent total hip arthroplasty (THA) or other hip surgery. Secondary endpoints were OA progression and PROMs.

Results

HA was performed in 92 consecutive patients from 1998 to 2006. Indications for HA were FAI, labral lesions, early OA, and focal osteochondral defects. Mean follow-up was 11.2 years (SD 2.5, range 7.9–16). Data from 43 patients were available for analysis; 38 patients were excluded, and 11 were lost to follow-up. 20 patients had subsequent hip surgery, of which 11 patients required THA. 33 patients (77%) stated that they would undergo HA again under the same circumstances. Longitudinal radiological analysis showed no significant OA progression in patients without THA. The Forgotten Joint Score-12 was the only PROM to significantly differ between patients who had no further surgery and patients who had undergone revision (p = 0.037).

Conclusion

There was no significant OA progression on plain radiography at an average of 11 years post-HA. Sound indication criteria is essential, as 45% of patients required subsequent surgery.

Byrd JWT, Jones KS (2009) Prospective analysis of hip arthroscopy with 10-year followup. Clin Orthop Relat Res 468(3):741–746. https://doi.org/10.1007/s11999-009-0841-7 CrossRefPubMedPubMedCentral

Londers J, Melkebeek J (2007) Hip arthroscopy: outcome and patient satisfaction after 5 to 10 years. Acta Orthop Belg 73(4):478PubMed

Stevens MS, LeGay DA, Glazebrook MA, Amirault D (2010) The evidence for hip arthroscopy: grading the current indications. Arthrosc J Arthrosc Relat Surg 26(10):1370–1383. https://doi.org/10.1016/j.arthro.2010.07.016 CrossRef

Clarke MT, Arora A, Villar RN (2003) Hip arthroscopy—complications in 1054 cases. Clin Orthop Relat Res 406(1):84–88CrossRef

McCarthy JC, Lee J (2005) Hip arthroscopy: indications, outcomes, and complications. J Bone Joint Surg 87(5):1137–1145CrossRef

Simpson J, Sadri H, Villar R (2010) Hip arthroscopy technique and complications. Orthop Traumatol: Surg Res 96(8):S287–S295. https://doi.org/10.1016/j.otsr.2010.09.010 CrossRef

Byrd JWT (2001) Hip arthroscopy: the supine position. Clin Sports Med 20(4):703–732CrossRefPubMed

Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494CrossRefPubMedPubMedCentral

Behrend H, Giesinger K, Geisinger JM, Kuster MS (2012) The “forgotten joint” as the ultimate goal in joint arthroplasty. J Arthroplast 27(3):430–436. https://doi.org/10.1016/j.arth.2011.06.035 CrossRef

10.

Nilsdotter AK, Lohmander LS, Klässbo M, Roos EM (2003) Hip disability and osteoarthritis outcome score (HOOS): validity and responsiveness in total hip replacement. BMC Musculoskelet Disord 4(1):10. https://doi.org/10.1186/1471-2474-4-10 CrossRefPubMedPubMedCentral

11.

Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:42–49

12.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51(4):737–755CrossRefPubMed

13.

Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA (2009) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction. Bone Jt J 91(1):16–23. https://doi.org/10.1302/0301-620X.91B1 CrossRef

14.

Ganz R, Leunig M, Leunig-Ganz K, Harris WH (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466(2):264–272. https://doi.org/10.1007/s11999-007-0060-z CrossRefPubMedPubMedCentral

15.

Herzog RF (2010) Hüftarthroskopie: therapeutische Möglichkeiten, Grenzen und Gefahren. Schweizerische Zeitschrift für Sportmedizin Sporttraumatologie 58(1):22–25

16.

Byrd JWT, Jones KS, Gwathmey FW (2016) Femoroacetabular impingement in adolescent athletes: outcomes of arthroscopic management. Am J Sports Med 44(8):2106–2111. https://doi.org/10.1177/0363546516648325 CrossRefPubMed

17.

Sansone M, Ahldén M, Jónasson P et al (2017) Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2-year follow-up. Scand J Med Sci Sports 27(2):230–235. https://doi.org/10.1111/sms.12641 CrossRefPubMed

18.

Wright JG, Einhorn TA, Heckman JD (2005) Grades of recommendation. J Bone Joint Surg Am 87(9):1909–1910. https://doi.org/10.2106/JBJS.8709.edit CrossRefPubMed

19.

Philippon MJ, Briggs KK, Yen Y-M, Kuppersmith DA (2009) Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Jt Surg Br 91(1):16–23. https://doi.org/10.1302/0301-620X.91B1.21329 CrossRef

20.

Meftah M, Rodriguez JA, Panagopoulos G, Alexiades MM (2011) Long-term results of arthroscopic labral debridement: predictors of outcomes. Orthopedics 34(10):e588–e592. https://doi.org/10.3928/01477447-20110826-04 CrossRefPubMed

21.

McCarthy JC, Jarrett BT, Ojeifo O, Lee J-A, Bragdon CR (2011) What factors influence long-term survivorship after hip arthroscopy? Clin Orthop Relat Res 469(2):362–371. https://doi.org/10.1007/s11999-010-1559-2 CrossRefPubMed

22.

Lynch TS, Terry MA, Bedi A, Kelly BT (2013) Hip arthroscopic surgery: patient evaluation, current indications, and outcomes. Am J Sports Med 41(5):1174–1189. https://doi.org/10.1177/0363546513476281 CrossRefPubMed

23.

Jacobsen S, Sonne-Holm S, Søballe K, Gebuhr P, Lund B (2004) The relationship of hip joint space to self reported hip pain. A survey of 4,151 subjects of the Copenhagen city heart study: the osteoarthritis substudy. Osteoarthr Cartil 12(9):692–697. https://doi.org/10.1016/j.joca.2004.05.010 CrossRef

24.

Philippon MJ, Arnoczky SP, Torrie A (2007) Arthroscopic repair of the acetabular labrum: a histologic assessment of healing in an ovine model. Arthroscopy 23(4):376–380. https://doi.org/10.1016/j.arthro.2007.01.017 CrossRefPubMed

25.

Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M (2006) Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Jt Surg Am 88(5):925–935. https://doi.org/10.2106/JBJS.E.00290 CrossRef

26.

Kelly BT, Weiland DE, Schenker ML, Philippon MJ (2005) Arthroscopic labral repair in the hip: surgical technique and review of the literature. Arthrosc: J Arthrosc Relat Surg 21(12):1496–1504. https://doi.org/10.1016/j.arthro.2005.08.013 CrossRef

27.

McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The Otto E (2001) Aufranc award: the role of labral lesions to development of early degenerative hip disease. Clin Orthop Relat Res 393:25–37CrossRef

28.

Murphy KP, Ross AE, Javernick MA, Lehman RA (2006) Repair of the adult acetabular labrum. Arthroscopy 22(5):567, e1–e3. https://doi.org/10.1016/j.arthro.2005.07.033.CrossRef

29.

Ferguson SJ, Bryant JT, Ganz R, Ito K (2003) An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech 36(2):171–178CrossRefPubMed

30.

Byrd JWT, Jones KS (2009) Hip arthroscopy in athletes: 10-year follow-up. Am J Sports Med 37(11):2140–2143. https://doi.org/10.1177/0363546509337705 CrossRefPubMed

31.

Homma Y, Baba T, Sano K et al (2016) Lateral femoral cutaneous nerve injury with the direct anterior approach for total hip arthroplasty. Int Orthop 40(8):1587–1593. https://doi.org/10.1007/s00264-015-2942-0 CrossRefPubMed

32.

Hamilton DF, Giesinger JM, MacDonald DJ, Simpson AHRW, Howie CR, Giesinger K (2016) Responsiveness and ceiling effects of the forgotten joint score-12 following total hip arthroplasty. Bone Jt Res 5(3):87–91. https://doi.org/10.1302/2046-3758.53.2000480 CrossRef

Title: Clinical and radiological outcome at mean follow-up of 11 years after hip arthroscopy
Authors: Martin Olach
Pascal Gerhard
Karlmeinrad Giesinger
Christoph Lampert
Johannes B. Erhardt
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-3024-8

At a glance: The STEP trials

Springer Medicine

Clinical and radiological outcome at mean follow-up of 11 years after hip arthroscopy

Abstract

Introduction

Objectives

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Objectives

Materials and methods

Results

Conclusion

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