Revision Hip Preservation Surgery With Hip Arthroscopy: Clinical Outcomes


      To analyze and report the clinical outcomes of a cohort of patients who underwent revision hip preservation with arthroscopy and determine predictors of positive and negative outcomes.


      During the study period from April 2008 to December 2010, all patients who underwent revision hip preservation with arthroscopy were included. This included patients who had previous open surgery and underwent revision with arthroscopy. Patient-reported outcome (PRO) scores were obtained preoperatively and at 3-month, 1-year, 2-year, and 3-year follow-up time points. Any revision surgeries and conversions to total hip arthroplasty were noted. A multiple regression analysis was performed to look for positive and negative predictive factors for improvement in PROs after revision hip arthroscopy.


      Forty-seven hips in 43 patients had completed 2 years' follow-up or needed total hip arthroplasty. The mean length of follow-up was 29 months (range, 24 to 47 months). Of the hips, 31 (66%) had either unaddressed or incompletely treated femoroacetabular impingement. There was a significant improvement in all PRO scores at a mean of 29 months after revision (P < .0001). The visual analog scale score improved from 7.3 ± 1.5 to 3.9 ± 2.5 (P < .0001). Improvements in the Non-Arthritic Hip Score of at least 10 points and 20 points were found in 28 hips (65%) and 19 hips (44%), respectively. Four hips in 3 patients required conversion to total hip arthroplasty. Positive predictive factors for PRO improvement were previous open surgery, pincer impingement, cam impingement, symptomatic heterotopic ossification, and segmental labral defects treated with labral reconstruction.


      On the basis of multiple PROs, revision hip preservation with hip arthroscopy can achieve moderately successful outcomes and remains a viable treatment strategy after failed primary hip preservation surgery. Preoperative predictors of success after revision hip arthroscopy include segmental labral defects, unaddressed or incompletely addressed femoroacetabular impingement, heterotopic ossification, and previous open surgery.

      Level of Evidence

      Level IV, therapeutic case series.
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        • Philippon M.J.
        • Schenker M.L.
        • Briggs K.K.
        • Kuppersmith D.A.
        • Maxwell R.B.
        • Stubbs A.J.
        Revision hip arthroscopy.
        Am J Sports Med. 2007; 35: 1918-1921
        • Heyworth B.E.
        • Shindle M.K.
        • Voos J.E.
        • Rudzki J.R.
        • Kelly B.T.
        Radiologic and intraoperative findings in revision hip arthroscopy.
        Arthroscopy. 2007; 23: 1295-1302
      1. Aprato A, Jayasekera N, Villar RN. Revision hip arthroscopic surgery: Outcome at three years. Knee Surg Sports Traumatol Arthrosc in press, available online 18 January, 2013. doi:10.1007/s00167-013-2373-7.

        • Bogunovic L.
        • Gottlieb M.
        • Pashos G.
        • Baca G.
        • Clohisy J.C.
        Why do hip arthroscopy procedures fail?.
        Clin Orthop Relat Res. 2013; 471: 2523-2529
        • Lodhia P.
        • Slobogean G.P.
        • Noonan V.K.
        • Gilbart M.K.
        Patient-reported outcome instruments for femoroacetabular impingement and hip labral pathology: A systematic review of the clinimetric evidence.
        Arthroscopy. 2011; 27: 279-286
        • Tijssen M.
        • van Cingel R.
        • van Melick N.
        • de Visser E.
        Patient-reported outcome questionnaires for hip arthroscopy: A systematic review of the psychometric evidence.
        BMC Musculoskelet Disord. 2011; 12: 117
        • Brooker A.F.
        • Bowerman J.W.
        • Robinson R.A.
        • Riley Jr., L.H.
        Ectopic ossification following total hip replacement. Incidence and a method of classification.
        J Bone Joint Surg Am. 1973; 55: 1629-1632
        • Boykin R.E.
        • Anz A.W.
        • Bushnell B.D.
        • Kocher M.S.
        • Stubbs A.J.
        • Philippon M.J.
        Hip instability.
        J Am Acad Orthop Surg. 2011; 19: 340-349
        • Domb B.G.
        • Martin D.E.
        • Botser I.B.
        Risk factors for ligamentum teres tears.
        Arthroscopy. 2013; 29: 64-73
        • Jackson T.J.
        • Stake C.E.
        • Trenga A.P.
        • Morgan J.
        • Domb B.G.
        Arthroscopic technique for treatment of femoroacetabular impingement.
        Arthrosc Tech. 2013; 2: e55-e59
        • Matsuda D.K.
        • Burchette R.J.
        Arthroscopic hip labral reconstruction with a gracilis autograft versus labral refixation: 2-Year minimum outcomes.
        Am J Sports Med. 2013; 41: 980-987
        • Krueger A.
        • Leunig M.
        • Siebenrock K.A.
        • Beck M.
        Hip arthroscopy after previous surgical hip dislocation for femoroacetabular impingement.
        Arthroscopy. 2007; 23: 1285-1289.e1