It has been shown that patients with femoroacetabular impingement (FAI) gain significant benefit from arthroscopy in terms of improvement in their symptoms. Some patients, however, will eventually undergo early surgery for total hip arthroplasty because of persistent symptoms. The precise causes of the poor prognosis in these patients have not yet been established.
A new study set out to identify the risk factors for early total hip arthroplasty in such patients.
A five-year database was used and the survival of patients’ hips after arthroscopy was studied, together with the demographic and individual characteristics of patients who underwent early total arthroplasty.
Patients who underwent hip arthroscopy for femoroacetabular impingement, aged between 12 and 63 years and with a minimum follow-up period of 2 years, were included. A total of 4,730 patients were studied.
In patients who underwent hip arthroscopy for femoroacetabular impingement, the overall rate of conversion to total hip arthroplasty within two years of the operation was 7%. The factors found to be associated with conversion to total arthroplasty were older age, osteoarthritis, inflammation of the joint and a history of opioid use. Older age, osteoarthritis, inflammation of the hip, a history of opioid use and also smoking were found to be independent factors associated with increased rates of conversion to total hip arthroplasty within two years of arthroscopy.
The authors of this study concluded that, although its findings are limited, patients with femoroacetabular impingement who are older and who carry a diagnosis of inflammatory joint disease, or who use opioids or tobacco, should be regarded as possible candidates for early conversion to total hip arthroplasty, and should therefore be counselled accordingly by their doctors.
Source: “Clinical Orthopaedics and Related Research”, June, 2020
