title: Long-term results of arthroscopic labral debridement: predictors of outcomes.
abstract: Limited data exist regarding the long-term results of labral debridement and the effect of coexisting pathology on outcomes. Our hypothesis was that untreated coexisting hip pathologies such as femoroacetabular impingement and arthritis significantly affect the outcomes of arthroscopic labral debridement. Between 1996 and 2003, fifty consecutive patients who underwent hip arthroscopy and labral debridement with a mean follow-up of 8.4 years were included in our study. Patients' preoperative Harris Hip Scores and coexisting pathologies such as femoroacetabular impingement, dysplasia, or arthritis were recorded as variables. Postoperative Harris Hip Score and satisfaction at final follow-up were recorded as outcomes. Good or excellent results were achieved in 62% of cases (58% in patients with untreated femoroacetabular impingement and 19% in patients with arthritis). Failures included 2 cases that were converted to total hip replacement (4.5 and 5.2 years after index procedure) due to advancement of arthritis and 1 case of repeat arthroscopy for cam decompression. Patients with no coexisting pathology had significantly higher satisfaction and Harris Hip Scores. Almost all of the patients with low postoperative Harris Hip Scores had arthritic changes. Arthritis had a significant correlation with low postoperative Harris Hip Scores and satisfaction. Coexisting pathology, especially arthritis and untreated femoroacetabular impingement, can result in inferior outcomes. Arthroscopic labral debridement of symptomatic tears in selected patients with no coexisting pathology can result in favorable long-term results. Arthritis is the strongest independent predictor of poor outcomes.
authors.affiliation: Hospital for Special Surgery and Weill Cornell Medical College, New York, USA. meftahm@hss.edu
authors.forename: Morteza
authors.initials: M
authors.lastname: Meftah
authors.forename: Jose A
authors.initials: JA
authors.lastname: Rodriguez
authors.forename: Georgia
authors.initials: G
authors.lastname: Panagopoulos
authors.forename: Michael M
authors.initials: MM
authors.lastname: Alexiades
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D005260:Female; D057925:Femoracetabular Impingement / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006304:Health Status; D006617:Hip Dislocation / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D025981:Hip Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult