Hip arthroscopy following contralateral total hip arthroplasty: a multicenter matched-pair study

Area of Science:

• Orthopedic Surgery
• Hip Preservation
• Arthroplasty

Background:

• Hip arthroscopy is a common procedure for labral pathology.
• Contralateral total hip arthroplasty (THA) may influence outcomes of hip preservation surgery.
• Patient-reported outcomes (PROs) are crucial for evaluating surgical success.

Purpose of the Study:

• To compare revision surgery rates and PROs in patients undergoing hip arthroscopy with a history of contralateral THA versus those with a native contralateral hip.
• To assess the impact of prior contralateral THA on the success of hip arthroscopy for labral pathology.

Main Methods:

• Retrospective review of patients undergoing hip arthroscopy (2008-2015).
• Inclusion criteria: Tönnis Grade 0-1, labral pathology, prior contralateral THA, and >2-year follow-up or THA conversion.
• Exclusion criteria: ipsilateral hip surgery, specific arthroscopic approaches, or hip dysplasia (LCEA < 20°).
• A 3:1 matched-pair analysis compared PROs and revision rates.

Main Results:

• No significant differences in modified Harris hip score, non-arthritic hip score, hip outcome score-sports specific sub-scale, visual analog pain score, or patient satisfaction.
• The study group (contralateral THA) had a 67% conversion rate to THA (6/9 patients) at an average of 30 months.
• The control group (native hip) had a 15% conversion rate to THA (4/27 patients) (P=0.006).

Conclusions:

• Hip arthroscopy in patients with prior contralateral THA is associated with a significantly higher rate of conversion to THA.
• Current evidence does not support recommending hip arthroscopy for patients with a history of contralateral THA due to high revision rates.
• Further research is needed to understand the factors contributing to these outcomes.