title: Outcome of arthroscopy in patients with advanced osteoarthritis of the hip.
abstract: Hip arthroscopy has continued to expand its horizons in treating many conditions other than femoroacetabular impingement (FAI). However, the results of hip arthroscopy are known to be poor if the degree of articular cartilage damage is significant. We wanted to assess, whether the procedure might have a role in the management of young and active patients with advanced osteoarthritis (OA) and whether it should be offered as a treatment modality. 77 consecutive patients with Tönnis grade 2 and 3 osteoarthritis of the hip who had undergone hip arthroscopy were included in the study. Patients' medical notes, plain radiographs and outcome scores (modified Harris hip score (mHHS), non-arthritic hip score (NAHS)) preoperatively and postoperatively at six weeks, six months, one year and annually thereafter, were analysed. 77 patients consisted of 63 men and 14 women with mean follow-up of 2.8 years (2.2 to 4.2) and mean age at surgery of 43 years (19 to 64). The mean preoperative mHHS and NAHS scores were 58 (28 to 87) and 64 (27 to 93) respectively. The mean improvements in both the mHHS and NAHS scores were significant (p = 0.003 and p = 0.0001 for mHHS at one and two years, p = 0.002 and p = 0.0003 for NAHS at one and two years, respectively). There were 34 patients (44%) who required a total hip replacement at mean of 18 months (6 to 48) after hip arthroscopy. We conclude that hip arthroscopy improves outcome scores in 56% of patients with severe OA of the hip (Tönnis grade 2 and 3) for at least two years after surgery. We thus consider the procedure to be a reasonable option for patients with hip OA, although success of the procedure will be less than if undertaken for certain other conditions.
authors: Spire Cambridge Lea Hospital, Cambridge, CB24 9EL, United Kingdom.
authors: Sachin
authors: S
authors: Daivajna
authors: Spire Cambridge Lea Hospital, Cambridge, CB24 9EL, United Kingdom.
authors: Ali
authors: A
authors: Bajwa
authors: Spire Cambridge Lea Hospital, Cambridge, CB24 9EL, United Kingdom.
authors: Richard
authors: R
authors: Villar
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000503:physiopathology; D005260:Female; D006615:Hip / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
references: Arthroscopy. 2000 Sep;16(6):578-87
references: 10976117
references: J Bone Joint Surg Br. 2008 Dec;90(12):1570-5
references: 19043126
references: Arthroscopy. 2012 Jan;28(1):59-65
references: 21982390
references: Orthopade. 1999 Sep;28(9):812-8
references: 10525692
references: Clin Orthop Relat Res. 2011 Jun;469(6):1667-76
references: 21181460
references: Clin Orthop Relat Res. 2007 Mar;456:128-32
references: 17106273
references: Sports Health. 2014 Jan;6(1):70-7
references: 24427445
references: N Engl J Med. 2008 Sep 11;359(11):1097-107
references: 18784099
references: J Bone Joint Surg Br. 2011 Mar;93(3):326-31
references: 21357953
references: Ann Chir Gynaecol. 2001;90(1):28-31
references: 11336365
references: Arthroscopy. 2009 Apr;25(4):365-8
references: 19341922
references: Reumatol Clin. 2007 Oct;3 Suppl 3:S50-3
references: 21794481
references: Chir Organi Mov. 1999 Jul-Sep;84(3):257-61
references: 11569040
references: J Bone Joint Surg Br. 2012 Apr;94(4):466-70
references: 22434460
references: Clin Orthop Relat Res. 2003 Jan;(406):75-83
references: 12579003
references: J Arthroplasty. 2013 Sep;28(8 Suppl):140-3
references: 23916639
references: Orthop Traumatol Surg Res. 2010 Dec;96(8 Suppl):S68-76
references: 21036688
references: J Bone Joint Surg Br. 2010 May;92(5):629-33
references: 20435997
references: Acta Orthop Belg. 2007 Dec;73(6):737-40
references: 18260486
references: Orthopedics. 2011 Oct;34(10):e588-92
references: 21956049
references: Sports Med Arthrosc Rehabil Ther Technol. 2010 Jul 29;2:18
references: 20670440
references: Clin Orthop Relat Res. 2011 Feb;469(2):362-71
references: 20872105
references: Am J Sports Med. 2007 Sep;35(9):1571-80
references: 17420508
references: Z Orthop Ihre Grenzgeb. 1979 Oct;117(5):808-15
references: 549339
references: Sports Med Arthrosc. 2013 Mar;21(1):23-30
references: 23314265
references: J Bone Joint Surg Am. 2014 Jan 15;96(2):113-8
references: 24430410