title: Hip arthroscopy in the setting of hip arthroplasty.
abstract: OBJECTIVE
  Hip arthroscopy has traditionally been viewed as a hip preservation procedure performed in patients with native joint pathology. However, as the list of indications for arthroscopic hip intervention grows, further advances are expanding its use. The purpose of this systematic review was to examine existing evidence supporting the use of hip arthroscopy in the setting of hip arthroplasty.
  
  
  METHODS
  Using predetermined inclusion criteria, EMBASE, MEDLINE and PubMed were searched for articles addressing arthroscopic hip surgery performed in hips containing joint replacement arthroplasties. Inclusion criteria limited our search to human and English language studies addressing articles where clear surgical indications are described. Article screening was conducted in duplicate.
  
  
  RESULTS
  Seven-hundred and forty-three studies were retrieved before duplicate screening, and 18 satisfied inclusion criteria. Eleven case series, six case reports and one prospective cohort study are included. In total, 171 patients underwent hip arthroscopy following previous arthroplasty. Indications for arthroscopy included iliopsoas tendinopathy (35.8%), symptomatic hips with no clear diagnosis despite extensive investigation (24.6%), periprosthetic infection (6.4%) and intra-articular loose bodies (3.5%). Almost all patients who underwent hip arthroscopy experienced positive outcomes from the procedure.
  
  
  CONCLUSIONS
  Hip arthroscopy after hip arthroplasty is supported by our systematic review for a variety of indications. Hip arthroscopy can be a safe and effective method of treating hip arthroplasty patients with iliopsoas tendinopathy. Hip arthroscopy also has utility in patients with symptomatic hip arthroplasty despite exhaustion of other diagnostic avenues.
  
  
  METHODS
  A systematic review of level IV studies.
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Heaven
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: Darren
authors.initials: D
authors.lastname: de Sa
authors.affiliation: Centre for Evidence Based Orthopaedics, Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Simunovic
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
authors.forename: D S
authors.initials: DS
authors.lastname: Williams
authors.affiliation: Division of Orthopaedic Surgery, London Health Sciences Centre-University Hospital, 339 Windermere Road, London, ON, N6A 5A5, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Naudie
authors.affiliation: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada. trauma7@mcmaster.ca.
authors.forename: O R
authors.initials: OR
authors.lastname: Ayeni
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D001182:Arthroscopy; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Hip arthroplasty; Hip arthroscopy; Iliopsoas tendinitis; Systematic review