Clinical Outcome

P195 - Identifying the most successful procedures in hip arthroscopy: A multivariate analysis of 1,000 surgeries

Authors
Corresponding Author
Disclosure
B.Domb: Research Support: Arthrex, Medacta, Stryker; Shareholder: American Hip Institute, Hinsdale Orthopedic Associates, Munster Specialty Surgery Center, North Shore Surgical Suites, SCD#3; Paid Instructor: Arthrex, Pacira Pharmaceuticals; Employee: AAN
Presentation Topic
Clinical Outcome
Poster Rating
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Abstract

Purpose

To determine if certain hip arthroscopic procedures are predictive are revision arthroscopy or total hip arthroplasty (THA).

Methods and Materials

From February 2008 and November 2015, data was collected prospectively and retrospectively reviewed. Inclusion criteria were patients undergoing hip arthroscopy for a labral tear with minimum two-year follow-up and between eighteen and sixty years old. Exclusion criteria were previous surgeries, Tönnis grade >1, and previous hip conditions.

Results

There were 1,521 eligible hips with follow-up for 1,118 patients (1,249 hips) (81.7%). The cohort had a mean age of 38.7 years (range:18.0, 60.0) and mean BMI of 26.4 (range 16.3, 48.9), with a mean followup was 50.2 months (24.0 – 111.9). 122(9.8%) patients converted to THA at a mean of 35.3 months (1.4, 95.2). Multivariate analysis for predictors of THA found age at surgery (HR=1.064/yr,p<.05), BMI (non-linear,p<.05), labral debridement (HR=1.558,p=0.03), trochanteric bursectomy (HR=0.367,p<.05), and notchplasty (HR=2.128,p<.05) as significant. 124(9.9%) patients underwent revision hip arthroscopy with a mean time to revision of 21.7 months (0.10, 83.3). Multivariate analysis for predictors of revision surgery found age at date of surgery (HR=0.973/yr,p<.05), worker’s compensation(HR=3.352,p<.05), capsular repair (HR=1.950,p<.05), femoral head chondroplasty (HR=0.241,p=0.05), and femoral head microfracture (HR=2.844,p=0.04) to be significant.

Conclusion

For 20 procedural variables, our multivariate model found notchplasty, labral debridement, and trochanteric bursectomy to be predictive for THA, while capsular repair, femoral head microfracture, and absence of femoral head chondroplasty to be predictive of revision arthroscopy. Numerous factors affect hip arthroscopy and understanding risk factors for conversion to THA or revision is paramount during discussions with patients.

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