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Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older

Marc J Philippon1, Bruno G Schroder E Souza, Karen K Briggs

  • 1Steadman Philippon Research Institute, Vail, Colorado 81657, USA. drphilippon@sprivail.org

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|October 11, 2011
PubMed

Insights

Hip arthroscopy offers improved function for older adults with femoroacetabular impingement and sufficient joint space. Patients with limited joint space may require early total hip replacement (THR).

Area of Science:

  • Orthopedic Surgery
  • Hip Arthroscopy
  • Femoroacetabular Impingement

Background:

  • Hip arthroscopy is a surgical procedure to treat hip joint problems.
  • Femoroacetabular impingement (FAI) is a common cause of hip pain, particularly in active individuals.
  • Assessing outcomes in older patient populations is crucial for treatment planning.

Purpose of the Study:

  • To evaluate the outcomes of hip arthroscopy in patients aged 50 years and older with FAI.
  • To determine the rate of conversion to total hip replacement (THR) and factors influencing it.
  • To assess functional improvements and patient satisfaction following the procedure.

Main Methods:

  • A prospective case series of 153 patients (aged ≥50 years) undergoing hip arthroscopy for FAI.
  • Data collected included range of motion, Modified Harris Hip Score (MHHS), Hip Outcome Score (HOS), and Short Form 12 (SF-12) scores.
  • Survivorship analysis (time to THR) was performed using the Kaplan-Meier method.

Main Results:

  • Twenty percent of patients (31/153) required THR.
  • At 3 years, survivorship was 90% for patients with >2 mm joint space versus 57% for those with ≤2 mm (P=.001).
  • Significant improvements were observed in MHHS, HOS (ADL and sports), and SF-12 physical component scores (P=.001 for all). Median patient satisfaction was 9/10.

Conclusions:

  • Hip arthroscopy can lead to significant improvements in pain and function for older FAI patients with adequate joint space.
  • Patients aged 50+ with FAI, ≤2 mm joint space, and low preoperative MHHS are at higher risk for early conversion to THR.
  • Joint space width is a critical predictor of long-term success after hip arthroscopy in this demographic.
Abstract

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