Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older

Abstract

Purpose: The purpose of this study was to investigate outcomes after hip arthroscopy in a consecutive series of patients aged 50 years or older and determine how long patients avoided total hip replacement.

Methods: Between 2006 and 2008, prospectively collected data were retrieved from our database on 153 patients aged 50 years or older undergoing hip arthroscopy for femoroacetabular impingement. Data collected included range of motion, Modified Harris Hip Score (MHHS), Hip Outcome Score (HOS) for activities of daily living, HOS for sports, and Short Form 12 score. Survivors were defined as patients not requiring total hip replacement (THR). Survivorship was analyzed by use of the Kaplan-Meier method.

Results: THR was required after the arthroscopic treatment in 20% of patients (31 of 153). At 3 years (with data available in 64 patients), patients with greater than 2 mm of joint space had survivorship of 90% whereas those with 2 mm or less had survivorship of 57% (P = .001). In the patients who did not require THR, the MHHS improved from 58 to 84. The HOS for activities of daily living improved from 66 to 87 (P = .001), and the HOS for sports improved from 42 to 72 (P = .001). The physical component of the Short Form 12 improved from 38 to 49 (P = .001), whereas the mental component did not change (54 preoperatively v 53 postoperatively, P = .53). Median patient satisfaction was 9.

Conclusions: On the basis of early results, patients with greater than 2 mm of joint space can expect improvement over preoperative status in pain and function after hip arthroscopy for femoroacetabular impingement. In patients aged 50 years or older with 2 mm of joint space or less and low preoperative MHHSs, early conversion to THR was seen.

Level of evidence: Level IV, therapeutic case series.