For the over-50 crowd, what are the mid-term outcomes of hip arthroscopy? Not finding many answers in the literature, researchers from the American Hip Institute in Chicago decided to go out and get them.
Their work, “Hip Arthroscopy in Patients Ages 50 Years or Older: Minimum 5-Year Outcomes, Survivorship, and Risk Factors for Conversion to Total Hip Replacement,” was published in the October 6, 2018 edition of Arthroscopy. Included in the study were 103 eligible cases, 94 hips with a minimum 5-year follow-up at a mean of 70.1 months.
Co-author Benjamin G. Domb, M.D., with Hinsdale Orthopedics and medical director of the American Hip Institute, told OTW, “Hip arthroscopy’s safety, favorable outcomes, high patient satisfaction, and low rate of conversion to THA [total hip arthroplasty] have been previously demonstrated for non-arthritic patients in the general population. However, we have yet to establish the durability of the procedure over longer term follow up, especially in the older population.”
Asked about the most controversial/unresolved aspects of this subject, Dr. Domb told OTW, “We know that hip arthroscopy is safe and efficacious for older patients. We also know that increased age at time of arthroscopy is associated with risk of subsequent THR [total hip replacement] and inferior surgical outcomes in general. Therefore, increasing age must be met with increasingly stringent indications for hip arthroscopy. However, little has been written about the mid-term outcomes of arthroscopy in patients over 50 years of age.”
“Although previous studies suggested that advanced age may contribute to a high failure rate at the short-term, our study demonstrated favorable outcomes and high durability mid-term outcomes. Our study demonstrated conversion rate to THA was 27.7% at a minimum 5 year follow up, a lower rate than in other studies with older populations.”
“As far as risk factors, our study is consistent with the literature regarding a lesser prognosis and higher conversion rate to THA specifically among patients with either dysplasia, arthritis, or high BMI. Overall, because of higher endpoint rates and risk factors with older age, it is important that clinicians carefully select and counsel older patients for hip arthroscopy.”
