Arthroscopic treatment of the hip in early and midstage degenerative joint disease

Abstract

The purpose of this study was to present the technique of arthroscopic capsule release in patients with early and midstage degenerative joint disease of the hip. In 22 patients we performed an arthroscopic capsular release of the hip joint capsule with simultaneous synovectomy and percutaneous drilling of areas of bone edema. The age of the patient ranged from 28 to 65 years (mean 52 years). There were 14 male and 8 female patients. All patients had suffered from a significant reduction of quality of life. In 15 of the 22 patients hip arthroplasty was already indicated in another institution. The preoperative Harris hip Score of 12 patients was below 69 points, 8 patients had a score between 70 and 79 points and 2 patients had a score between 80 and 89 points. At the time of follow-up (mean 26 months after surgery) 1 patient scored below 69 points, 3 patients scored between 70 and 79 points in the Harris hip score. Two patients scored between 80 and 89 points and 16 patients reached a score between 90 and 100 points. Subjective and objective 18 of 22 patients showed clinical relevant improvement. There was no complication in this series. Four patients underwent hip arthroplasty between 6 months and 2 years after the arthroscopic procedure. Minimal invasive arthroscopic treatments seem to decrease the subjective and objective complaints in early and midstage degenerative arthritis of the hip.

The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients

“…The mean time interval for mild OA was 2.2 years (range, 0.2-5 years) whereas for severe OA it was 1.1 years (range, 0.1-5.1 years). These findings correlate with previous publications on short term results [3-6]. In addition, Margheritini and Villar [5] showed that young patients with early OA were those associated with a higher rate of procedure success, similar to our observation of longer time intervals to THA in patients younger than 55.…”

Does Arthroscopic FAI Correction Improve Function with Radiographic Arthritis?

“…Similar to our study, Horisberger et al reported a 60% (12 patients) failure rate using non-arthritic hip score (NAHS) in 20 patients with radiographic OA (Tonnis Grades 1-3) at a mean last followup of 3 years [14]. Most studies evaluating hip arthroscopy in the setting of OA predate FAI bony resections [4,8,13,17,18,23,27,35] ( Table 6). Margheritini and Villar [23] evaluated 133 patients with hip OA who underwent hip arthroscopy and reported a 39% failure rate at a mean followup of 18 months using the HHS.…”

“…Studies show that the presence of OA negatively impacts outcomes after hip arthroscopy and nonarthroplasty open hip surgery [2,4,8,13,14,17,18,23,25,27,[29][30][31][32]35]. However, most studies predate FAI correction, are limited to small numbers, or lack well-defined independent predictors of improved function or failure rates after managing FAI in the presence of OA.…”

“…This disorder can result in labral-chondral injury and eventual osteoarthritic changes in the hip [2,7,10,25,29]. Numerous studies show the presence of OA negatively impacts improvements in pain and function after hip arthroscopy and nonarthroplasty open hip surgery [2,4,8,13,14,17,18,23,25,27,[29][30][31][32]35]. However, the majority of these studies predate resection of FAI impingement lesions [4,8,13,17,18,23,27,35], or are limited to small numbers [2,14,25,32].…”

Feasibility of arthroscopic placement of autologous matrix-induced chondrogenesis grafts in the cadaver hip joint

“…In this level of evidence study a successful outcome rate of 89% is reported. Jerosch et al 4 . showed good to excellent outcome results in 82% of a case series.…”