Related Experiment Video
Updated: Aug 26, 2025
The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Staging Bilateral Hip Arthroscopies Less Than 1 Year Apart May Reduce the Risk of Revision Surgery
Pradip Ramamurti1, Pramod Kamalapathy1, Brian C Werner1
1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A.
Insights
Staging bilateral hip arthroscopy less than one year apart reduces revision surgery risk. Optimal timing for hip arthroscopy depends on individual patient factors for best outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Bilateral hip arthroscopy is increasingly common.
- The optimal timing between staged procedures is not well-defined.
- Understanding timing impacts patient outcomes and resource utilization.
Purpose of the Study:
- To determine the influence of timing between staged bilateral hip arthroscopy on medical and surgical complications.
- To analyze the impact of timing on revision rates and conversion to total hip arthroplasty (THA) within two years.
Main Methods:
- Retrospective analysis of the Mariner data set (PearlDiver database).
- Stratification of patients into four cohorts based on time between arthroscopies (≤3 months, 3-6 months, 6-12 months, >1 year).
- Multivariate logistic regression to control for confounding variables.
Main Results:
- A total of 998 patients underwent staged bilateral hip arthroscopy.
- The 2-year revision rate was 7.6%, with 1.9% converting to THA.
- Procedures staged less than one year apart showed a significantly decreased risk of revision compared to those staged over one year apart (P < .05).
- No significant differences in medical or surgical complications were observed between cohorts staged less than one year apart.
Conclusions:
- Staging bilateral hip arthroscopy within one year is associated with a reduced risk of revision surgery.
- The precise timing within the one-year interval did not affect medical or surgical complication rates.
- Patient-specific factors should guide the optimal timing for staged bilateral hip arthroscopy to minimize revision risk.
Purpose:
To identify the influence of timing between staged bilateral hip arthroscopy on 90-day postoperative medical complications and 2-year surgical complications including revision, conversion to total hip arthroplasty (THA), and infection.
Methods:
The Mariner data set of the PearlDiver all-payer claims database was queried for patients undergoing staged bilateral hip arthroscopy. Patients were stratified into cohorts based on time between arthroscopies: (1) ≤3 months, (2) 3 to ≤6 months, (3) 6 to ≤12 months, and (4) >1 year. Multivariate logistic regression was utilized to control for any confounding variables.
Results:
In total, 998 patients underwent staged bilateral hip arthroscopy out of 38,080 patients who underwent primary hip arthroscopy. The 2-year revision rate was 7.6% for all patients undergoing bilateral hip arthroscopy, while 1.9% of patients underwent conversion to THA. Patients with arthroscopy procedures staged less than 1 year apart (cohorts 1, 2, and 3) had significantly decreased risk of revision compared to the greater than 1 year cohort (P = .008, .025, and .044, respectively). There were no differences in rates of major medical, minor medical, or remaining surgical complications between the cohorts. Direct comparisons between the cohorts staged ≤1 year apart showed no significant differences in medical or surgical complications (P > .05).
Conclusions:
The revision rate in all patients undergoing staged bilateral hip arthroscopy was 7.6%. Staging hip arthroscopy ≤1 year apart was associated with a decreased risk of revision when compared to the staged cohort >1 year. Among those staged less than 1 year, the timing of staging had no association with rates of medical or surgical complications. Patients who are indicated for bilateral hip arthroscopy may benefit from staging under 1 year apart to reduce the risk of revision surgery. Optimal timing decisions may be patient specific and rely on the duration of symptoms, severity of pathology, or progression of rehabilitation after the index procedure.
Level Of Evidence:
III, retrospective comparative study.
