title: Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger.
abstract: OBJECTIVE
  Age has been suggested as a negative prognostic factor for hip arthroscopy. The purpose of this study was to compare patient characteristics and outcomes after hip arthroscopy in patients aged 50 years or older with a matched control group of patients aged 30 years or younger at a minimum postoperative follow-up of 2 years.
  
  
  METHODS
  Between September 2008 and March 2010, data were prospectively collected on all patients aged 50 years or older undergoing primary hip arthroscopy. Fifty-two patients met our inclusion and matching criteria, of whom all 52 (100%) were available for follow-up at a minimum of 2 years. This cohort was compared with a matched-pair control group of patients aged 30 years or younger who underwent similar procedures.
  
  
  RESULTS
  The mean age of the study group was 54.8 years (range, 50 to 69 years), and that of the control group was 20.3 years (range, 13 to 30 years). The groups were matched at a 1:1 ratio, including 18 male patients (34.6%) and 34 female patients (65.4%) in each group, with a mean follow-up period of 32 months (range, 24 to 54 months). In the younger control group, the score improvement from preoperatively to 2 years' follow-up was 62.9 to 84.2 for the modified Harris Hip Score, 60.5 to 84.2 for the Non-Arthritic Hip Score, 63.1 to 86.5 for the Hip Outcome Score-Activities of Daily Living, and 42.2 to 72.7 for the Hip Outcome Score-Sport-Specific Subscale. In the older study group, the score improvement from preoperatively to 2 years' follow-up was 61.2 to 82.2 for the modified Harris Hip Score, 59.9 to 80.4 for the Non-Arthritic Hip Score, 63.9 to 83 for the Hip Outcome Score-Activities of Daily Living, and 41.2 to 64.6 for the Hip Outcome Score-Sport-Specific Subscale. All improvements in both groups were statistically significant at the 2-year postoperative follow-up (P < .001). There was no significant difference for all patient-reported outcome (PRO) scores at final follow-up between both groups. When we compared the change in PRO scores (Δ) from preoperatively to 2 years postoperatively, there was no significant difference between both groups. The overall survivorship rate was 98.1% for the younger control group and 82.7% for the older study group.
  
  
  CONCLUSIONS
  Survivors aged 50 years or older show similar improvement to patients aged 30 years or younger in PRO and patient satisfaction scores. The 2-year survivorship rate was 98.1% for the younger control group and 82.7% for the older study group. Therefore we believe that hip arthroscopy should be considered a valid treatment option when treating hip pain in patients aged 50 years or older with a Tönnis arthritic grade of 0 or 1. Older patients should be counseled on the possibility of later conversion to total hip arthroplasty. Future work may include development of a decision-making tool to assess for prognosis to better delineate the indications for hip arthroscopy in the older population.
  
  
  METHODS
  Level III, therapeutic case-control study.
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.; Hinsdale Orthopaedics, Hinsdale, Illinois, U.S.A.; Loyola University Stritch School of Medicine, Chicago, Illinois, U.S.A. Electronic address: drdomb@americanhipinstitute.org.
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Domb
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Dror
authors.initials: D
authors.lastname: Linder
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Finley
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Itamar B
authors.initials: IB
authors.lastname: Botser
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Austin
authors.initials: A
authors.lastname: Chen
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Joseph
authors.initials: J
authors.lastname: Williamson
authors.affiliation: American Hip Institute, Westmont, Illinois, U.S.A.
authors.forename: Asheesh
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001182:Arthroscopy; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D055815:Young Adult