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Primary hip arthroscopy had greater improvements in outcomes vs revision arthroscopy
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While patient-reported outcomes, pain and satisfaction scores significantly improved after hip arthroscopy, primary arthroscopic surgery had higher outcome scores and a trend toward greater improvement in pain scores compared with revision arthroscopy, according to results.
Researchers preoperatively and postoperatively assessed modified Harris Hip score (mHHS), non-arthritis hip score and the hip outcome score activities of daily living (HOS-ADL) and sport specific subscales (HOS-SSS) for 824 patients who underwent 931 primary hip arthroscopy procedures and for 97 patients who underwent 107 revision hip arthroscopy procedures. Researchers also estimated pain using the VAS and measured patient satisfaction.
Results showed improvement in all postoperative scores compared with preoperative scores. At 2-year follow-up, researchers found a mean change of 17.4 points in the mHHS; of 19.7 points in the HOS-ADL; of 23.8 points in the HOS-SSS; of 21.3 points in the non-arthritis hip score and of –3 points in the VAS for patients who underwent primary hip arthroscopy vs. 13.4 points, 10.9 points, 16.1 points, 15.4 points and –2.7 points, respectively, in the revision hip arthroscopy group. At all time points, patients in the primary hip arthroscopy group had higher patient reported outcome scores. Researchers noted mean satisfaction of 7.7 in the primary group and of 7.2 in the revision group, as well as an overall complication rate of 4.3%.
Overall, 5.6% of primary arthroscopic procedures were converted to total hip arthroplasty (THA)/hip resurfacing (HR) vs. 11.2% of revision arthroscopic procedures. Compared with primary procedures, researchers noted a relative risk of THA/HR of 2 after revision procedures. After primary hip arthroscopy, researchers found a cumulative incidence of competing risks of conversion to THA/HR of 2.6% and revision hip arthroscopy of 5.8%. – by Casey Tingle
Disclosures: Domb reports personal fees and others from Arthrex, Mako Surgical and Pacira; support from Breg and ATI; personal fees from Stryker, Orthomerica, DJO Global and Amplitude; and is a board member of the American Hip Institute. Please see the full study for a list of all other authors’ relevant financial disclosures.
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