title: Does Primary Hip Arthroscopy Result in Improved Clinical Outcomes?: 2-Year Clinical Follow-up on a Mixed Group of 738 Consecutive Primary Hip Arthroscopies Performed at a High-Volume Referral Center.
abstract: BACKGROUND
  Hip arthroscopy has gained increasing popularity over the past decade. The need to develop metrics to evaluate success and complications in primary hip arthroscopy is an important goal.
  
  
  OBJECTIVE
  To evaluate 2-year patient-related outcome (PRO) scores and patient satisfaction scores for a single surgeon at a high-volume referral center for all primary hip arthroscopy procedures performed.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  During the study period between April 2008 and October 2011, data were collected on all patients who underwent primary hip arthroscopy. All patients were assessed pre- and postoperatively with 4 PRO measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS). Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. The number of patients who underwent revision arthroscopy, total hip arthroplasty (THA), or a resurfacing procedure during the study period was also reported.
  
  
  RESULTS
  A total of 595 patients were included in the study. The score improvement from preoperative to 2-year follow-up was 61.29 to 82.02 for mHHS, 62.79 to 83.05 for HOS-ADL, 40.96 to 70.07 for HOS-SSS, 57.97 to 80.41 for NAHS, and 5.86 to 2.97 for VAS. All scores were statistically significantly different (P < .0001). Overall patient satisfaction was 7.86 ± 2.3 (range, 1-10). Forty-seven (7.7%) patients underwent revision hip arthroscopy, and 54 (9.1%) patients underwent either THA or the hip resurfacing procedure during the study period. The multivariate regression analysis showed that increased age at time of surgery was a significant risk factor for conversion to THA, revision arthroscopy, and change in NAHS <10 points. Acute injury, acetabuloplasty, iliopsoas release, and patient sex were significant for 2 of these 3 types of failure.
  
  
  CONCLUSIONS
  Primary hip arthroscopy for all procedures performed in aggregate had excellent clinical outcomes and patient satisfaction scores at short-term follow-up in this study. More studies must be conducted to determine the definition of a successful outcome. There was a 6.1% minor complication rate, which was consistent with previous studies. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty as well as the potential for revision surgery.
authors: American Hip Institute, Westmont, Illinois, USA.
authors: Asheesh
authors: A
authors: Gupta
authors: American Hip Institute, Westmont, Illinois, USA.
authors: John M
authors: JM
authors: Redmond
authors: American Hip Institute, Westmont, Illinois, USA.
authors: Christine E
authors: CE
authors: Stake
authors: American Hip Institute, Westmont, Illinois, USA.
authors: Kevin F
authors: KF
authors: Dunne
authors: American Hip Institute, Westmont, Illinois, USA Hinsdale Orthopaedics, Westmont, Illinois, USA Loyola University Chicago Stritch School of Medicine, Westmont, Illinois, USA DrDomb@americanhipinstitute.org.
authors: Benjamin G
authors: BG
authors: Domb
mesh_terms: D065526:Acetabuloplasty / Q000379:methods; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006276:Health Facility Size; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction; D010808:Physical Examination / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012017:Referral and Consultation; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult
keywords: FAI; high-volume referral center; hip arthroscopy; labral tears; outcomes