Timing in hip arthroscopy: does surgical timing change clinical results?

To our knowledge, there is no report in the orthopaedic literature that correlates the duration of hip pain with the results of hip arthroscopic surgery. The aim of this study was to compare the modified Harris Hip Score (mHHS) with patient satisfaction in a prospective study over a two year period.

We present a prospective single-surgeon series of 525 consecutive patients undergoing hip arthroscopy for a labral tear, femoroacetabular impingement (FAI), or a chondral lesion. Modified HHS was recorded for all patients at the time of surgery and at six weeks, six months and one, two and three years after hip arthroscopy. At the time of surgery, patients were divided into three groups based on duration of preoperative symptoms: group A, under 6 months; group B, six months to three years; group C, over three years.

Mean age was 39 years. There were significantly better outcomes for patients who underwent surgery within six months of symptom onset compared with those who waited longer. Patients who had symptoms for over 3 years by the time of surgery had a significantly poorer result than those with a shorter symptom duration and a higher chance of requiring revision surgery.

We recommend that patients with a diagnosis of labral tear, FAI or a chondral lesion should undergo hip arthroscopic surgery within six months of symptom onset. Patients with persistent symptoms for over three years should be made aware of the poorer outcome after hip arthroscopy.