Editorial Commentary: Hip Arthroscopy in Patients With Symptomatic Spine Pathology: Patient Education Supported by...

Concomitant correctable and uncorrectable pathologies can impact outcomes after any orthopaedic procedure. The relationship between hip joint disorders and spine-related disorders has been increasingly recognized and reported in the literature. A number of studies have reported poorer outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement with associated symptomatic low back and sacroiliac dysfunction. A few studies, however, have noted that the magnitude of improvement after hip arthroscopy is similar between patients with and without spine pathology despite inferior outcomes associated with symptomatic spine disease. A couple of studies have contradicted these data and noted comparable outcomes after hip arthroscopy for isolated hip pain versus those with hip and spine pain. This is clearly a complex kinetic chain association, and the contradicting literature might be more about how we evaluate the data; set appropriate physician/patient expectations; perform a thorough workup, including diagnostic injections; and carefully navigate our way through this patient population rather than buying into a concrete conclusion one way or another. When faced with a patient population riddled with hip- and spine-related pathology, we are walking through a minefield of unpredictable patient-related outcomes. We need to use our evidence and experience-based map to avoid these mines of failure and safely march toward a successful outcome.