The Outcome of Hip Arthroscopy in the Setting of Lumbar Spine Disease Is Beneficial, Yet Limited: A Systematic Review of Existing Evidence

Outcomes of Hip Arthroscopy in the Setting of Concomitant Symptomatic Lumbosacral Spine Pathology: A Matched Control Study With Minimum 24-Month Follow-up

“…13,15,50 Ultimately, loss of spinopelvic mobility may exacerbate hipspecific symptoms in patients with FAI, as activities requiring high degrees of hip flexion (eg, sitting, squatting) inherently perpetuate mechanical injury to the chondrolabral complex. 13,15 The link between spinopelvic mobility and pelvic sagittal alignment has been well-documented in THA literature, where extremes of pelvic alignment, lumbar disease, previous fusion surgery, and stiffness have been associated with impingement, dislocation, early failure, and need for revision surgery. [11][12][13]23,26 While a thorough preoperative workup and optimal implant selection/positioning may mitigate adverse events after THA, literature reporting outcomes in the setting of hip preservation remains limited.…”

“…1,15,25 However, secondary analyses continue to be limited given the paucity of available studies that use heterogeneous patient populations, variable outcome metrics, and short lengths of follow-up. 1,4,15,25,43 The purpose of this present study was to conduct a matched, case-control analysis to assess the influence of symptomatic lumbosacral pathology on hip arthroscopy outcomes for patients with FAI and symptomatic labral tears. Borrowing from available literature, we hypothesized that preexisting lumbosacral spine pathology would adversely affect patient-reported outcome measures (PROMs), rates of achieving clinically significant postoperative outcome thresholds (eg, minimal clinically important difference [MCID] and Patient Acceptable Symptom State [PASS]), need for revision arthroscopy, and conversion to THA.…”

“…Three recent systematic reviews have largely surmised that patients with FAI who have lumbosacral pathologies experience improved but inferior outcomes after hip arthroscopy compared with controls without concomitant spinal conditions. 1,15,25 However, secondary analyses continue to be limited given the paucity of available studies that use heterogeneous patient populations, variable outcome metrics, and short lengths of follow-up. 1,4,15,25,43…”

“…13,23,50 However, over time, compensatory variations in lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope can accelerate arthrosis in facet joints, leading to lower back pain, stiffness, and possible lumbar stenosis. 13,15,50 Ultimately, loss of spinopelvic mobility may exacerbate hipspecific symptoms in patients with FAI, as activities requiring high degrees of hip flexion (eg, sitting, squatting) inherently perpetuate mechanical injury to the chondrolabral complex. 13,15 The link between spinopelvic mobility and pelvic sagittal alignment has been well-documented in THA literature, where extremes of pelvic alignment, lumbar disease, previous fusion surgery, and stiffness have been associated with impingement, dislocation, early failure, and need for revision surgery.…”

“…13,23,50 However, over time, compensatory variations in lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope can accelerate arthrosis in facet joints, leading to lower back pain, stiffness, and possible lumbar stenosis. 13,15,50 Ultimately, loss of spinopelvic mobility may exacerbate hip-specific symptoms in patients with FAI, as activities requiring high degrees of hip flexion (eg, sitting, squatting) inherently perpetuate mechanical injury to the chondrolabral complex. 13,15…”