Chicago orthopedic surgeon, Benjamin Domb, MD, founder of the American Hip Institute, conducted a survival analysis of patients following hip arthroscopy procedures. From February 2008 to June 2012, Dr. Domb and his colleagues collected data from all patients undergoing primary or revision hip arthroscopy procedures. Researchers collected data from over 1,000 patients over a four year period. American Hip Institute researchers are still collecting research on the ongoing study.
The study aims to compare the outcomes of primary hip arthroscopy versus revision hip arthroscopy to determine which procedure yielded better outcomes for patients.
"We were interested to see how many patients continued to survive their native hip joint after primary hip arthroscopy," explains Dr. Domb. "There were two options of further intervention for these patients: revision hip arthroscopy or Total Hip Arthroscopy/Hip Resurfacing."
Dr. Domb and his colleagues hypothesized patient undergoing primary hip arthroscopy would have less conversions to THA/HR, and would have substantially better patient-reported outcomes, compared to those patients undergoing revision hip arthroscopy. Based on researchers' two year follow-up analysis, their hypothesis was confirmed.
Researchers assessed patients pre- and post-operatively with modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score-Activities of Daily Living and Hip Outcome Score-Sport Specific Subscales. To assess pain, patients estimated their pain on the visual analog scale, and patient satisfaction was determined on a scale from 0 to 10.
In the study, 6.2 percent of cases from the entire cohort, 5.6 percent of cases in the primary hip arthroscopy subgroup, and 11.2 percent of cases in the revision hip arthroscopy subgroup were converted to THA/HR during the study period. The relative risk of conversion to THA/HR in patients undergoing revision hip arthroscopy was 2.0.
Additionally, 8.5 percent of cases from the entire cohort, 8.3 percent of cases in the primary arthroscopy subgroup, and 10.3 percent of cases in the revision hip arthroscopy subgroup required a subsequent revision arthroscopy.
While the study's results proved promising, more research is needed on the benefits of hip arthroscopies.
"Further research on this topic is paramount, as we currently still do not know the longevity of symptom-free health state in patients undergoing primary and revision hip arthroscopies," says Dr. Domb. "The latter is a newer topic as hip arthroscopy is gaining popularity and we are seeing more and more patients in this subgroup that may benefit from revision hip arthroscopy. The overall goal of future research is to elucidate the indications for revision hip arthroscopy and hopefully identify those patients that would most benefit from a re-look."
Dr. Domb presented these findings at International Society for Hip Arthroscopy's Annual Meeting on Sept. 23 to Sept. 26 in Cambridge, England.