Hip Arthroscopy in Osteoarthritis: A Systematic Review of the Literature

Piuzzi, Nicolás S.; Slullitel, Pablo; Bertona, Agustín; Oñativia, José Ignacio; Albergo, Ignacio; Zanotti, Gerardo; Buttaro, Martín; Piccaluga, Francisco; Comba, Fernando

doi:10.5301/hipint.5000299

Cited by 19 publications

(19 citation statements)

References 31 publications

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“…Although we have found that there is some postoperative clinical outcome improvement of pain and function in a short-term evaluation, increasingly worse outcomes where seen as the severity of OA increased. At the present we found that level of evidence is low to support the indication a hip arthroscopy in the presence of advanced preoperative osteoarthritis 20 . Labral and chondrolabral lesions were the most frequent intraoperative findings in our series.…”

Section: Discussioncontrasting

confidence: 54%

Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years

Yacuzzi

Ali

Zanotti

et al. 2019

Muscle Ligaments and Tendons J

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Background: The purpose of this study is to evaluate the clinical outcomes, radiological degenerative progression and the joint preservation rate in a series of patients with Femoroacetabular Impingement (FAI) treated with hip arthroscopy at a minimum follow-up of 7 years. The predictive factors for total hip arthroplasty (THA) requirement were analyzed. Materials and methods: Between February 2008 and February 2009, 42 consecutive patients treated with hip arthroscopy due to FAI syndrome were included. There were 15 women and 27 men with an average age of 38 years (range 23 to 56 years). The surgery involved joint damage stabilization (labral tears and/or chondrolabral injuries) and correction of associated bony deformities (cam and/or pincer lesions). A prospective clinical follow-up was made with no patient lost. We specifically addressed the need for THA. Predictive factors for THA were also analyzed. Results: At final follow up, joint preservation rate was 83.33% (CI 95% 68,64%-93,03%). Probability of evolving to a THA in patients with radiographic preoperative Tonnis grades 0 and I was of 0% (CI 95%: 0-12.77). Probability of evolving to a THA in patients with preoperative Tonnis grades II and III was 46,67% (CI 95%21.27%-73,41%). A statistically significant difference was present between both groups (p= 0.002). Patients older than 45 years at the time of hip arthroscopy were at significant risk of evolving to a THA (p=0.0012). Excluding those patients who undergone a THA: modified HHS was 88.25 points (80-96) and radiographic analysis addressed a 14,29% (IC95% 4,81%-30,26%) of progressive degenerative changes without affecting clinical results. Conclusions: Hip arthroscopy for the treatment of patients with FAI syndrome showed favorable results regarding joint preservation. Patients with preoperative radiographic evidence of advanced-stage osteoarthritis and those older than 45 years at the time of surgery have higher risk of requiring THA. Level of evidence: IV.

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Section: Discussioncontrasting

confidence: 54%

Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years

Yacuzzi

Ali

Zanotti

et al. 2019

Muscle Ligaments and Tendons J

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“…On the contrary, patients with a joint space wider than 2 mm significantly improved the mHHS, Short Form 12 and HOS scores at 3-year follow-up. This means that age did not constitute an independent risk factor for articular failure, but only if related with a severe joint space narrowing; as reported by the former systematic review [24]. However, a retrospective study on hip preservation following hip arthroscopy at 5-year follow-up evidenced that age older than 45 at the time of surgery was an independent risk factor for THA [37].…”

Section: Discussionmentioning

confidence: 95%

Arthroscopic acetabuloplasty without labral detachment for focal pincer-type impingement: a minimum 2-year follow-up

Slullitel

Bronenberg

Zanotti

et al. 2017

Journal of Hip Preservation Surgery

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In order to access and resect the acetabular rim, arthroscopic acetabuloplasty was described with labral detachment. When the chondrolabral junction remains intact, acetabuloplasty and labral refixation can be performed maintaining an unharmed labrum. We aimed to evaluate the outcome of a group of patients treated with arthroscopic acetabuloplasty without labral detachment. During the study period, we retrospectively analysed 44 patients with pincer-type o combined impingement and an intact chondroblabral junction, with an average follow-up of 32 months (range: 27–38). We excluded patients with isolated CAM-type impingement and previous hip pathology. Radiographs were analysed to define impingement and classify grade of osteoarthritis. Clinical evaluation consisted of pre-operative and post-operative modified Harris hip score (mHHS) and WOMAC as well as post-operative visual analogue scale (VAS) of pain and satisfaction. Reoperations were considered surgical failures for purposes of survival analysis. Mean mHHS changed from 51.06 (SD 4.81) pre-operatively to 84.97 (SD 12.79) post-operatively. Pre-operative WOMAC was 29.18 (SD 8) and post-operative, 13.10 (SD 11). Post-operative VAS was 7.5 and 2.27 for satisfaction and pain, respectively. When comparing patients with Tönnis 0 to those with Tönnis 1, the former showed better results regarding post-operative mHHS (89.9 s versus 77.85, P = 0.03), pain VAS (1.5 versus 6.3, P = 0.03) and satisfaction VAS (8.2 versus 6.3, P = 0.01). Survival was 100% at 24 months and 76% at 40 months (95% CI: 35–98%). Arthroscopic acetabuloplasty without labral detachment achieved good clinical outcomes. Slight degenerative changes on radiographs correlated with poorer clinical outcomes.

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“…Studies regarding clinical outcomes after hip arthroscopy in middle-aged patients with early osteoarthritis of various diagnoses are uncommon 15,16) . This study demonstrates that:…”

Section: Discussionmentioning

confidence: 99%

“…Although pain and clinical symptoms improve after hip arthroscopy, surgical outcomes in patients with more severe osteoarthritis became worse 15,16) . Horisberger et al 22) identified that those with Tönnis grade III have poorer prognoses compared with those with Tönnis <III.…”

Section: Discussionmentioning

confidence: 99%

“…However, clinical outcomes after hip arthroscopy in middle-aged patients with early osteoarthritis rather than with specific diagnoses (e.g., femoroacetabular impingement [FAI], labral tears) are rarely reported 15,16) . Therefore, the authors analyzed patients undergoing hip arthroscopic surgery among symptomatic patients aged 40 years or older with hip osteoarthritis.…”

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confidence: 99%

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Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

et al. 2020

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In the context of increased life expectancy, the number of patients in older age groups aiming to live an active life has been on the rise, despite their higher risk of developing osteoarthritis and hip osteoarthritis specifically 1). Recently, due to quicker postoperative recovery, and pain reduction compared to open surgical procedures 2) , hip arthroscopy is gaining popularity as a hip-preserving surgical approach for those presenting with hip joint lesions 3-5). Hip arthroscopy in young patients has been proven as an effective treatment option 6-8) , while its effects in relatively

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Hip Arthroscopy in Osteoarthritis: A Systematic Review of the Literature

Cited by 19 publications

References 31 publications

Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years

Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years

Arthroscopic acetabuloplasty without labral detachment for focal pincer-type impingement: a minimum 2-year follow-up

Midterm-clinical Outcomes after Hip Arthroscopy in Middle-aged Patients with Early Osteoarthritis

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