Which factors affect the long-term survival of the joint after hip arthroscopy?

Clin Orthop Relat Res, Sep 2010
McCarthy JC, Jarrett BT, Ojeifo O, Lee JA, Bragdon CR.
Harris Orthopaedic Laboratory, Massachusetts General Hospital, 55 Fruit Street, Yawkey 3B, Boston, MA, 02115, USA, jcmccarthy1@partners.org.
Hip arthroscopy is an evolving technique. A small study in the past suggested that a low Harris Hip Score and arthritis at the time of hip arthroscopy were predictors of a poor prognosis.
The authors' purpose was to confirm these findings in a large, homogeneous group of patients, in order to determine the non-arthritic hip score in the long term, to determine survival, to identify the risk factors that increase the likelihood of total hip arthroplasty, and to use those factors to create a risk assessment algorithm.
324 patients (340 hips) who had undergone hip arthroscopy for pain and/or mechanical symptoms were reviewed retrospectively. Of these, 106 patients (111 hips, or 33%) had a minimum follow-up of 10 years (mean 13 years, range 10-20 years). The mean age was 39 years (+/- 13), with 47 men and 59 women. Age, sex, the Outerbridge grade of chondral lesions in the acetabulum and the femoral head, and the presence or absence of a tear of the labrum were recorded. Patients were followed using the non-arthritic hip score or the date of a subsequent total hip arthroplasty. Survival was determined using total hip arthroplasty as the endpoint.
Survival in the 111 hips was 63% at 10 years. The mean non-arthritic hip score for the patients who did not ultimately undergo total hip arthroplasty was 87.3. Survival was greater in cases where the grade of chondral lesions in the acetabulum and the femoral head was zero to II. Age at the time of hip arthroscopy and the Outerbridge grade independently predicted subsequent total hip arthroplasty. Sex and the presence of a labral tear did not affect long-term survival.
The authors concluded that, on the basis of long-term survival, hip arthroscopy is a suitable technique for the treatment of labral tears.