Hip Arthroscopy in Patients Age 40 or Older: A Systematic Review

Horner, Nolan S.; Ekhtiari, Seper; Simunovic, Nicole; Safran, Marc R.; Philippon, Marc J.; Ayeni, Olufemi R.

doi:10.1016/j.arthro.2016.06.044

Cited by 98 publications

(81 citation statements)

References 82 publications

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“…Individuals older than 42 years presented an elevated risk of revisit after hip arthroscopy. Although a small series of patients over 50 years old demonstrated remarkable improvements after hip arthroscopy for femoroacetabular impingement [19,39], other studies in alignment with our results associated increased age with an elevated risk of hospital revisits across a range of hospital procedures and diagnoses [18,19,[40][41][42][43][44]. One previous study specifically reported that after discharge, the 14-day revisit rate among elderly patients was 29%, which is in contrast with a 15% rate among younger individuals [43].…”

Section: Floridasupporting

confidence: 67%

Hip Arthroscopy: Spatiotemporal Analysis in Three US States and Predictor of Revisit after a Procedure

Pedrinelli¹,

Hernandez²,

Ejnisman³

et al. 2018

Orthop Muscular Syst

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Objective: The incidence of hip arthroscopy procedures has recently increased, current trends demonstrating a wide geographical variation and relatively similar functional outcomes among a wide age range. We aimed to evaluate spatio-temporal trends in state variation of hip arthroscopy procedures as well as the rate and determinants of 90-day hospital revisits. Methods: This was a secondary spatiotemporal analysis of data on hip arthroscopy procedures from the Healthcare Cost and Utilization Project databases, including the State Inpatient Database (SID), the State Ambulatory Surgery Database and the State Emergency Department Database (SEDD) for Florida, Kentucky, and Maryland, spanning a total of six years (2009-2014). Revisit risk was only evaluated through Florida data. Results: Out of 4,085 patients, the mean age was 40.7 years, 60.5% were female, 81.4% white, 77.7% had private insurance, and 96.5% were located in metropolitan areas. The average Charlson co-morbidity score was 0.11 (± 0.39), the Van Walraven score was 0.17 (± 1.51). Revisit rates progressively decreased during the study period, from 13.3% in 2009 to 6.2% in 2014 (p for trend < 0.001). Age >42 [OR: 2.13 (1.7, 2.69)] and a Charlson comorbidity score >0 [OR: 2.35 (1.73, 3.16)] were risk factors for a revisit. Paying mechanisms other than Medicare were protective. Most revisits (93.19%) occurred in the first 25 days after the procedure and the 90-day revisit rates for the State of Florida were centered on the major metropolitan areas such as West Palm Beach, Sarasota, Tampa, and Orlando. The incidence of hip arthroscopies increased in most parts of Florida, Kentucky, and Maryland over the study period. Conclusion: Revisit rates may reflect the quality of care and highlight the need for improvement. Future registries should include patient factors like pre-operative function and social determinants of health that might influence outcomes and revisit rates.

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Section: Floridasupporting

confidence: 67%

Hip Arthroscopy: Spatiotemporal Analysis in Three US States and Predictor of Revisit after a Procedure

Pedrinelli¹,

Hernandez²,

Ejnisman³

et al. 2018

Orthop Muscular Syst

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show abstract

“…Despite being significantly older than high-level athletes, recreational athletes still had great outcomes after hip arthroscopy for femoroacetabular impingement, an important finding given that results of hip arthroscopy in older patient populations appear mixed at this time. 6,7 Documented success of hip arthroscopy in an older athletic cohort will prove invaluable with the increasing number of "baby boomers" coming to our office. We do not reserve hip arthroscopy for the athletic elite, and we want to help all patients who previously have not been thought of as "ideal candidates.…”

Section: See Related Article On Page 748mentioning

confidence: 99%

Editorial Commentary: Put Me in Coach! Hip Arthroscopy Gets Patients Back in the Game

Kane¹,

Philippon²

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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A significant proportion of patients undergoing hip arthroscopy for treatment of femoroacetabular impingement are athletes attempting to return to sport. Emerging data suggest hip arthroscopy has a high success rate in athletes returning to play at all competitive levels and ages. Although several factors are important in determining return to athletics, the results of hip arthroscopy appear promising in all athletes, from weekend warriors to elite professionals.

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“…Prior studies have clearly identified high hip arthroscopy failure rates in the presence of significant degenerative changes that become more prevalent with increasing age. [2][3][4][5] Kester et al 3 reviewed a large statewide database of patients undergoing hip arthroscopy and found a conversion rate to THA of 5.9% at a mean of 14.7 months. They found that increasing age, index procedure performed by a low-volume surgeon, female sex, obesity, and increased degenerative changes were risk factors for THA conversion.…”

Section: See Related Article On Page 2736mentioning

confidence: 99%

“…They found that increasing age, index procedure performed by a low-volume surgeon, female sex, obesity, and increased degenerative changes were risk factors for THA conversion. Horner et al 2 performed a systematic review of patients aged 40 years or older who underwent hip arthroscopy. In addition to reporting that obesity and arthritic changes predicted poor outcomes, they reported that the rate of conversion to THA was 18.1% for patients aged 40 years or older, 23.1% for patients older than 50 years, and 25.2% for patients older than 60 years, with a mean time to THA of 25.0 months.…”

Section: See Related Article On Page 2736mentioning

confidence: 99%

Editorial Commentary: Total Hip Arthroplasty After Hip Arthroscopy—Solution for the Failed Arthroscopy or a Matter of Pushing the Envelope and Questionable Indications

Larson¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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With the inevitable explosion of arthroscopic hip procedures being performed, the less frequent indications and failures are becoming prevalent enough to analyze. As with any procedure, failures occur and solutions are sought after. "Total hip arthroplasty after prior hip arthroscopy" is a statement that brings to mind several questions and comments. Yes, it is important to evaluate the impact of a prior arthroscopy on eventual total hip arthroplasty outcomes and complication rates. The bigger question when the arthroplasty is performed less than 2 years after hip arthroscopy, however, is "How did we get here?" The pivotal issue at hand might be one of pushing surgical indications a bit too forcefully on multiple fronts. It might be time to return to "Indications 101" to minimize an exponential increase regarding this particular topic with this particular failure timeline.

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Hip Arthroscopy in Patients Age 40 or Older: A Systematic Review

Cited by 98 publications

References 82 publications

Hip Arthroscopy: Spatiotemporal Analysis in Three US States and Predictor of Revisit after a Procedure

Hip Arthroscopy: Spatiotemporal Analysis in Three US States and Predictor of Revisit after a Procedure

Editorial Commentary: Put Me in Coach! Hip Arthroscopy Gets Patients Back in the Game

Editorial Commentary: Total Hip Arthroplasty After Hip Arthroscopy—Solution for the Failed Arthroscopy or a Matter of Pushing the Envelope and Questionable Indications

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