Outcomes of Hip Arthroscopy for Femoroacetabular Impingement in Chinese Patients Aged 50 Years or Older

Abstract

ObjectiveTo investigate the outcomes of hip arthroscopy for femoroacetabular impingement (FAI) in patients over the age of 50 years.MethodThis is a therapeutic case series study. A total of 27 FAI patients over the age of 50 years who met inclusion and exclusion criteria and were being followed up for at least 2 years in the orthopaedics department at our hospital between January 2015 and October 2017 were recruited for a prospective analysis on the outcomes of hip arthroscopy. All patients underwent unilateral surgery. Of the patients included, there were 15 men and 12 women, who were aged 50–74 years old (57 ± 6.4 years). The outcomes were assessed using the visual analog scale (VAS), the modified Harris hip score (mHHS), and the International Hip Outcome Tool (iHOT‐12).ResultsA total of 27 patients were followed up for at least 2 years. The postoperative center‐edge angle, the alpha angle, and the offset decreased significantly compared with preoperative measurements (P < 0.01). The mHHS before surgery and at 1 year and 2 years after surgery was 62.19 ± 7.47, 86.70 ± 5.80, and 87.89 ± 5.08, respectively; iHOT‐12 scores were 30.44 ± 4.22, 73.56 ± 3.89, and 73.77 ± 3.72, respectively; VAS scores were 6.07 ± 0.78, 1.93 ± 0.73, and 1.59 ± 0.64, respectively. As compared with the condition before surgery, there was a significant improvement in the mHHS, iHOT‐12, and VAS scores at 1 year and 2 years after surgery (P < 0.01). The mHHS score at 2‐year follow up after surgery was higher than that at 1 year after surgery, and the difference observed was statistically significant (P = 0.04). One patient with severe acetabular and femoral cartilage damage underwent total hip replacement 11 months after surgery.ConclusionHip arthroscopy considerably improved hip symptoms and function in Chinese FAI patients aged 50 years or older who did not have severe radiographic osteoarthritis. The conversion to THA and complications were low. Strict surgical indications and appropriate surgical strategies lay the foundation for satisfactory postoperative results in elderly patients with FAI.

The Application of Arthroscopic Techniques in the Diagnosis and Treatment of Hip‐Related Conditions in China

“…This technique is also effective for middle‐aged and older adult patients. In a therapeutic case series study 26 , a total of 27 FAI patients over the age of 50 years were being followed up for at least 2 years. Imaging results and clinical follow‐up results showed that hip arthroscopy significantly improved hip symptoms and functions in Chinese FAI patients over 50 years without severe radiographic osteoarthritis (OA).…”

What the papers say

“…The authors [ 1 ] from Daejeon, Korea report a therapeutic prospective case series. A total of 27 patients over the age of 50 years with femoroacetabular impingement (FAI) underwent hip arthroscopy were analysed.…”

Outcomes of arthroscopy of the hip for femoroacetabular impingement based on intraoperative assessment using the Outerbridge classification

“…3 This induces repeated microtrauma during certain movements, particularly flexion and internal rotation of the hip, leading to damage at the chondrolabral junction and osteoarthritis (OA) in some patients. 4 The initial management of FAI involves conservative measures with physiotherapy, 5 which may address associated conditions such as muscular imbalance, abductor fatigue, and extra-articular impingement. 6 When conservative treatment fails, surgery in the form of open surgical dislocation or hip arthroscopy (HA) can be offered.…”