The success of hip arthroscopy in an active-duty military population

A recently published paper from military hospitals in the USA set out to assess the results of arthroscopic treatment of the hip in a young and active military population. In particular, the ability to return to military duties was assessed as a principal marker of success. In addition, an objective assessment was made of various demographic factors, as well as factors related to the operation, in order to identify the predictors of success or failure of treatment in this military population.
A retrospective chart review was carried out in order to assess the results of hip arthroscopy at a single academic military medical centre. A total of 206 patients underwent 223 hip arthroscopies over a period of 13 years (from 2000 to 2013). Of these, 159 patients met the inclusion criteria, which required active military service with at least 12 months of follow-up. Veterans, serving military personnel and those with less than 12 months of follow-up were excluded. The operations were performed by one of five specialist orthopaedic surgeons.
In total, 159 patients were available for the study, 102 men and 57 women. The mean age of the patients was 30.9 ± 8.3 years (range 18 to 52 years). The commonest diagnosis was femoroacetabular impingement (FAI) and the commonest technique performed was acetabuloplasty. 22% of patients underwent assessment by the hospital's medical team after hip arthroscopy and were excluded from military service. 78% of patients continued in active military duties after hip arthroscopy. The overall complication rate was 15.7%, with a major complication rate of 1.25% comprising fracture of the femoral neck, abdominal compartment syndrome, osteonecrosis, deep vein thrombosis, pulmonary embolism and septic arthritis. Statistical analysis showed that the presence of a complication is a significant factor for failure and return to military duties.
The authors concluded that hip arthroscopy in a military population is effective for the treatment of a range of conditions and for keeping service personnel in their active military duties. Complications of any kind, whether from the operation itself or postoperative, are significant prognostic factors for the discontinuation of their military service.
Source: “Arthroscopy”, August 2016