The Incidence of Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome and Labral Pathology Increased by 85% Between 2011 and 2018 in the United States

Zusmanovich, Mikhail; Haselman, William; Serrano, Brian; Banffy, Michael B.

doi:10.1016/j.arthro.2021.04.049

Cited by 99 publications

(46 citation statements)

References 28 publications

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“…Between 2011 and 2018, the incidence of hip arthroscopy increased by 85%. 49 Consequently, the number of patients requiring revision hip arthroscopy has also increased. 21 The most common causes of primary failed hip arthroscopy are labral retear and inaccurate cam morphology correction.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Achieving the Maximal Outcome Improvement Threshold for Willingness to Undergo Revision Hip Arthroscopy

et al. 2022

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Background: The maximal outcome improvement threshold for willingness to undergo revision hip arthroscopy (MOWT) has not been defined yet. Purpose: To determine the percentage MOWT in patients who underwent revision hip arthroscopy and to identify predictors of achieving the MOWT. Study Design: Case-control study; Level of evidence, 3. Methods: An anchor question was provided to patients who underwent revision hip arthroscopy between April 2008 and June 2020 who returned for follow-up between August 2019 and June 2021 at one institution. Patients were included if they underwent revision hip arthroscopy, had answered the anchor question, and had baseline and postoperative minimum 1-year follow-up scores for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and the visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia, previous hip conditions, or unwillingness to participate. Receiver operating characteristic analysis was used to determine the MOWT. Multivariate logistic regression was used to determine intraoperative predictors of achieving the MOWT. Results: In total, 153 patients (163 hips) were included, with 117 female hips (71.8%), a mean patient age of 34.3 ± 12.4 years, and an average follow-up time of 61.6 ± 42.7 months. It was determined that 77.3% of the patients reported that they would choose to undergo the revision hip arthroscopy again. The MOWT for the mHHS, NAHS, and VAS was 43.1%, 53%, and 33.4%, respectively. The probability of choosing to undergo revision surgery if the MOWT was achieved was 77.5%, 77.6%, and 79.2%, for the mHHS, NAHS, and VAS, respectively. Patients with residual cam-type morphology, which was addressed during the revision, were 2.3 times more likely to achieve the MOWT for the VAS ( P = .014). Conclusion: Patients who improved 43.1%, 53%, and 33.4% of their MOWT for the mHHS, NAHS, and VAS, respectively, were likely to be willing to undergo revision hip arthroscopy again. Moreover, the presence of residual cam-type femoroacetabular impingement morphology before their revision surgery was identified as a predictor to achieve the MOWT for the VAS.

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Section: Discussionmentioning

confidence: 99%

“…Due to the rising increase in primary hip arthroscopic surgeries, 49 revision hip arthroscopy has become a challenging situation that patients and surgeons are facing more frequently. 25 Currently, rates of secondary procedures range between 5% and 14%.…”

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confidence: 99%

Predictors of Achieving the Maximal Outcome Improvement Threshold for Willingness to Undergo Revision Hip Arthroscopy

et al. 2022

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“…In a recent study by Zusmanovich et al, the authors identified an 85% increase in the incidence of hip arthroscopy for those with FAI Syndrome (FAIS) and labral pathology, treating more than twice as many females than male patients. 1 Similarly, Cevallos et al noted a twofold increase in the incidence of hip arthroscopy from 2010 to 2014, with no significant change from 2014 to 2017 and a 70% female patient population, in greater than 50,000 cases. In this study, they also identified an almost 20% revision rate with 15.1% of patients having revision arthroscopy within the first 2 years postoperatively and 3.9% of patients converting to a total hip arthroplasty.…”

Section: Introduction Background and Argument For A Comprehensive Movement Approachmentioning

confidence: 94%

Beyond the Basics of Athletic Hip Evaluation

Campbell

Voight

2022

Arthroscopy, Sports Medicine, and Rehabilitation

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There is a growing trend in the world of orthopedics and sports medicine revolving around the nonarthritic hip. The incidence of hip arthroscopy has exponentially grown in the past decade and despite the importance of the recognition of these hip pathologies as contributors to pain and dysfunction, there is an ever-increasing rate of "failed" procedures emerging in the literature. The etiology of femoroacetabular impingement (FAI) syndrome and associated pathologies of the hip are now better understood. With this understanding there appears a tendency to point a finger at the hip joint without consideration for the involvement of the surrounding joints or extraarticular structures. Because of the nature of the morphological condition of FAI and the high incidence of a gradual progression of pain and impairments over time, as opposed to an acute injury, there is a need for a more robust assessment of the hip. The purpose of this commentary is to discuss the importance of a combined traditional orthopedic exam, imaging, and movement assessment in diagnosis and treatment recommendations in those with nonarthritic hip pain. It is our belief that this combined model can assist in identifying movement dysfunction that may lead to poor surgical outcomes and developing improved nonoperative or preoperative care pathways. Level of evidence: Level V.

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“… 1 However, with advancements in surgical instrumentation, coupled with a greater understanding of pathology, the number of arthroscopic hip procedures has risen markedly, reflected in an 18-fold increase in arthroscopic hip operations between 1999 and 2009 2 , 3 and an 85% rise between 2011 and 2018. 4 Patients undergoing hip arthroscopy typically demonstrate significant improvement in outcomes. 5 , 6 , 7 Current indications for arthroscopic hip surgery include lavage of a septic joint, loose body removal, labral repair, management of trochanteric pain, treatment of capsular or synovial disorders, and correction of femoroacetabular impingement (FAI).…”

mentioning

confidence: 99%

Surgical Technique of the “Up-The-Neck” View During Hip Arthroscopy for Femoroacetabular Impingement

Mengers

Strony

Vakharia

et al. 2022

Arthroscopy Techniques

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The Incidence of Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome and Labral Pathology Increased by 85% Between 2011 and 2018 in the United States

Cited by 99 publications

References 28 publications

Predictors of Achieving the Maximal Outcome Improvement Threshold for Willingness to Undergo Revision Hip Arthroscopy

Predictors of Achieving the Maximal Outcome Improvement Threshold for Willingness to Undergo Revision Hip Arthroscopy

Beyond the Basics of Athletic Hip Evaluation

Surgical Technique of the “Up-The-Neck” View During Hip Arthroscopy for Femoroacetabular Impingement

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