Hip osteoarthritis is a degenerative disease, that is wear of the joint, which causes a high degree of disability in the patient. The symptoms include difficulty in moving and also pain, both on physical activity and at rest. When the conservative treatment options are exhausted the patient needs surgical treatment, and the definitive solution is total arthroplasty. The latter is a major operation in which the worn joint is replaced and complete relief from the symptoms is achieved. In younger patients in particular, however, the decision to undergo a radical operation is a difficult one, since the materials used have a defined lifespan, while at the same time the scope for physical activity is restricted.
Hip arthroscopy is a surgical procedure that is minimally invasive, and that has been used in recent years to correct various pathological conditions of the hip joint. The scope of arthroscopy was nevertheless considered limited in osteoarthritis, since an improvement in symptoms was not always seen in this group of patients. The published evidence on the use of arthroscopy in hip osteoarthritis has been mixed over the past ten years.
A new study, however, has provided new evidence on the effectiveness of hip arthroscopy in osteoarthritis. This study was carried out in three separate centres in Ireland. The researchers studied a large number of patients with hip osteoarthritis who underwent arthroscopy and compared the results with a matched control group. All the patients were assessed for the survivorship of their hip, that is, the length of time the native hip remained without undergoing total arthroplasty. The results were particularly positive for the group that underwent arthroscopy, since 57% of them showed that their hip survived for ten years, and in this group of patients 78% consider the results to have been satisfactory.
This study has highlighted the encouraging results for this group of patients. For young patients in particular, bearing in mind that total arthroplasty is a technique that leads to an irreversible result, hip arthroscopy, as a technique carried out through very small portals, as day-case surgery — that is, without the patient staying overnight — and with a significantly low likelihood of complications, is a very good option for the relief of the symptoms of hip osteoarthritis.
Source: “Arthroscopy” (Arthroscopy Association of North America), February 2023
