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Favorable Outcomes of Revision Hip Arthroscopy Irrespective of Whether Index Surgery was Performed by the Same
Hari K Ankem1, Samantha C Diulus, Cynthia Kyin
1From the American Hip Institute Research Foundation, Des Plaines (Dr. Ankem, Diulus, Kyin, Dr. Jimenez, Dr. Maldonado, Dr. Sabetian, Dr. Saks, Dr. Lall, Dr. Domb); AMITA Health St. Alexius Medical Center, Hoffman Estates (Dr. Saks, Dr. Lall, Dr. Domb); and the American Hip Institute, Des Plaines (Dr. Lall, Dr. Domb), IL.
Introduction:
The purpose of this study was to compare minimum 2-year patient-reported outcomes (PROMs) after revision hip arthroscopy between two different patient cohorts who had undergone primary hip arthroscopy with the same surgeon (SS) and a different surgeon (DS). We hypothesized no difference in clinical outcomes between the groups despite differences in intraoperative findings based on the surgical decision making in a revision setting at a high-volume center.
Methods:
Between January 2012 and August 2017, 71 SS patients were matched for age, sex, body mass index, and follow-up to 71 DS patients. Modified Harris hip score (mHHS), nonarthritic hip score, and hip outcome score-sports-specific subscale (HOS-SSS) were collected prospectively. The minimal clinically important difference was calculated for mHHS and HOS-SSS.
Results:
All the DS patients had labral tears, and 94.4% had femoroacetabular impingement from residual bony deformity (P < 0.001). The SS and DS groups demonstrated significant and comparable improvement in mHHS (Δ = 18.3 ± 21.5 versus 19 ± 20.1; P = 0.837), nonarthritic hip score (Δ = 18.8 ± 18.8 versus 18.2 ± 18.8; P = 0.850), and HOS-SSS (Δ = 22 ± 27.4 versus 17.5 ± 28.1; P = 0.275). The rates of achieving minimal clinically important difference for mHHS and HOS-SSS were similar. Furthermore, the need for revision surgery and conversion to total hip arthroplasty were comparable (P = 0.228 and P = 0.383).
Conclusions:
Patients undergoing revision hip arthroscopy reported notable and comparable improvement in multiple patient-reported outcomes at a minimum 2-year follow-up, irrespective of intraoperative findings or primary source of patient pool.
