What factors influence long-term survivorship after hip arthroscopy?
BACKGROUND
Hip arthroscopy is an evolving procedure. One small study suggested that a low modified Harris hip score and arthritis at the time of surgery were predictors of poor prognosis.


OBJECTIVE
We therefore intended to confirm those findings with a large patient cohort to (1) determine the long-term nonarthritic hip score; (2) determine survivorship; (3) identify risk factors that increase the likelihood of THA; and (4) use those factors to create a usable risk assessment algorithm.


METHODS
We retrospectively reviewed 324 patients (340 hips) who underwent arthroscopy for pain and/or catching. Of these, 106 patients (111 hips or 33%) had a minimum followup of 10 years (mean, 13 years; range, 10-20 years). The average age was 39 years (± 13) with 47 men and 59 women. We recorded patient age, gender, acetabular and femoral Outerbridge grade at surgery, and the presence of a labral tear. Followup consisted of a nonarthritic hip score or the date of a subsequent THA. We determined survivorship with the end point of THA for the acetabular and femoral Outerbridge grades.


RESULTS
Overall survivorship among the 111 hips was 63% at 10 years. The average nonarthritic hip score for non-THA patients was 87.3 (± 12.1). Survivorship was greater for acetabular and femoral Outerbridge grades normal through II. Age at arthroscopy and Outerbridge grades independently predicted eventual THA. Gender and the presence of a labral tear did not influence long-term survivorship.


CONCLUSIONS
The long-term survivorship of labral tears with low-grade cartilage damage indicates hip arthroscopy is reasonable for treating labral tears.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
McCarthy
Joseph C
JC
Harris Orthopaedic Laboratory, Massachusetts General Hospital, 55 Fruit Street, Yawkey 3B, Boston, MA 02115, USA. jcmccarthy1@partners.org
Jarrett
Bryan T
BT
Ojeifo
Olumide
O
Lee
Jo Ann
JA
Bragdon
Charles R
CR
D000077:Acetabulum / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology; D002648:Child; D005260:Female; D005269:Femur / Q000473:pathology; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult