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

Abstract

ObjectiveTo assess the incidence of total hip arthroplasty (THA) in osteoarthritic patients who were treated by arthroscopic debridement and to evaluate factors that might influence the time interval from the first hip arthroscopy to THA.DesignRetrospective clinical seriesMethodsFollow-up data and surgical reports were retrieved from 564 records of osteoarthritic patients that have had hip arthroscopy between the years 2002 to 2009 with a mean follow-up time of 3.2 years (range, 1-6.4 years). The time interval between the first hip arthroscopy to THA was modelled as a function of patient age; level of cartilage damage; procedures performed and repeated arthroscopies with the use of multivariate regression analysis.ResultsNinety (16%) of all participants eventually required THA. The awaiting time from the first arthroscopy to a hip replacement was found to be longer in patients younger than 55 years and in a milder osteoarthritic stage. Patients that experienced repeated hip scopes had a longer time to THA than those with only a single procedure. Procedures performed concomitant with debridement and lavage did not affect the time interval to THA.ConclusionsIn our series of arthroscopic treatment of hip osteoarthritis, 16% required THA over a period of 7 years. Factors that influence the time to arthroplasty were age, degree of osteoarthritis and recurrent procedures.

Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older

“…Several articles have used Tönnis grade as a descriptive for outcome studies [6,9,13,15,16,22,25]. One recent article excluded patients with Tönnis Grade 2 or greater and greater than 50% narrowing of the joint space and still had 8% conversion to THA [16].…”

Does the Nature of Chondrolabral Injury Affect the Results of Open Surgery for Femoroacetabular Impingement?

“…Specific to the severity of the chondral injury, other authors have reported a relationship between the severity of the chondral injury and treatment failure [3,6,13,17]. These reports specifically describe large delaminated cartilage lesions as being associated with failure although specific treatment of these lesions was variably performed and reported.…”

Intraoperative Cartilage Degeneration Predicts Outcome 12 Months After Hip Arthroscopy

“…The observed area and thickness of articular cartilage loss were graded as follows: Grade 0 = no degeneration; Grade 1 = localized articular cartilage loss (partial-thickness acetabulum); Grade 2 = partial-thickness loss at the acetabulum and femoral head (\ 30% of the acetabular anterior wall width involved, with full-thickness articular cartilage loss); Grade 3 = full-thickness acetabulum ([ 30%) and partialthickness femoral head; and Grade 4 = full-thickness loss on both surfaces [9]. This grading system was based on the early Outerbridge system for grading patellofemoral degeneration [19].…”