Satisfaction, functional outcomes and predictors in hip arthroscopy: a cohort study
Mara R van der Valk1, Nienke Wolterbeek1, Tijmen van Assen2
1Department of Orthopaedic surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Insights
Older age and longer symptom duration negatively impact hip arthroscopy outcomes. While no specific risk factors for revision or total hip replacement were identified, patient satisfaction remains a key consideration.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Patient Outcomes Research
Background:
- Hip arthroscopy success rates vary, with a notable percentage of patients proceeding to total hip arthroplasty (THA).
- Identifying predictors for THA, revision arthroscopy, and patient dissatisfaction is crucial for optimizing hip preservation strategies.
Purpose of the Study:
- To identify risk factors associated with THA, revision arthroscopy, and low patient satisfaction following primary hip arthroscopy.
- To compare the outcomes of different primary hip arthroscopy procedures.
Main Methods:
- Analysis of 91 primary hip arthroscopies in 90 patients.
- Data collection via patient files and questionnaires assessing Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS), EuroQol 5-dimension, return to sports, satisfaction, and pain.
- Regression analyses to identify predictive factors for outcomes.
Main Results:
- After a mean follow-up of 1.6 years, 4% underwent revision arthroscopy and 11% had THA.
- 66% of responding patients reported satisfaction with the surgery.
- Higher age predicted lower satisfaction (p=0.008), and longer symptom duration predicted worse mHHS scores (p=0.005).
Conclusions:
- Older age is a significant predictor of reduced patient satisfaction after hip arthroscopy.
- Prolonged symptom duration negatively influences functional outcomes.
- No specific risk factors were identified for THA or revision arthroscopy, and procedural outcomes were comparable.
Introduction:
Hip arthroscopy is not always successful, leading to high rates of total hip arthroplasty (THA) after arthroscopy. The aim of this study was to identify risk factors for THA, revision arthroscopy and low patient satisfaction and to compare outcomes of the different procedures of primary hip arthroscopy.
Methods:
A total of 91 primary hip arthroscopy procedures in 90 patients (66% female) were analysed. Data were gathered from patient files and a questionnaire was sent to patients including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS), the EuroQol 5-dimension and questions about return to sports, satisfaction and pain before and after surgery. Using regression analyses, predictive factors for the outcomes were identified.
Results:
After a mean of 1.6 years, 4 patients (4%) underwent revision arthroscopy and 10 (11%) a THA. Of the responders (62%), 66% of the patients was satisfied to very satisfied about the surgery. Mean mHHS score was 75.3 (SE 1.9) and the mean WOMAC score was 81.0 (SE 2.8). Return to sports rate was 58%. A higher age was a significant predictor for lower satisfaction (p = 0.008) and a longer duration of symptoms was a significant predictor for worse mHHS outcome scores (p = 0.005).
Conclusion:
A higher age is a predictor for a lower satisfaction and a longer duration of symptoms before surgery has a negative influence on functional outcome. No risk factors for THA or revision arthroscopy were found and there were no significant differences in outcome measurements between the performed surgeries.
