Purpose
The purpose of this study was to (1) evaluate the clinical outcomes of a series of
patients aged 60 years or older who underwent hip arthroscopy for labral tears with
minimum 2-year follow-up and (2) identify risk factors for conversion to total hip
arthroplasty (THA).
Methods
Outcome data were prospectively collected and retrospectively reviewed in patients
aged 60 years or older who underwent hip arthroscopy between April 2008 and May 2012.
Four patient-reported outcome (PRO) scores, pain scores, and satisfaction ratings
were collected. Conversion to THA and revision surgery rates were recorded. A subgroup
analysis compared survivors with patients requiring THA.
Results
Minimum 2-year follow-up was available for 30 patients with a mean age of 63.9 years.
The 2-year survivorship rate was 70%, with 9 patients undergoing conversion to THA
at a mean of 1.1 years after hip arthroscopy. Two patients required additional surgery
during the study period, for a reoperation rate of 37% (11 of 30 patients). The remaining
cohort showed mean improvements in all PRO scores. All scores, except the sports-related
PRO (P = .12), improved significantly from the preoperative baseline scores. Visual analog
scale scores for pain decreased from a mean of 5.0 preoperatively to 2.7 postoperatively
(P = .003). Patients who required conversion to THA had lower preoperative modified
Harris Hip Scores (P = .015), lower preoperative Hip Outcome Score–Activity of Daily Living values (P = .01), higher pain scores (P = .05), greater acetabular inclination (P = .023), and more severe chondral damage (P = .033).
Conclusions
Arthroscopic treatment of labral tears in patients aged 60 years or older should be
approached with caution. Patients in this age group had an overall 2-year survivorship
rate of 70% and should be counseled before surgery on the possibility of subsequent
conversion to THA. Patients aged 60 years or older with poor preoperative PRO scores,
high pain scores, radiographic evidence of borderline dysplasia, and severe chondral
damage may be poor candidates for hip arthroscopy.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: May 18, 2015
Accepted:
March 19,
2015
Received:
September 3,
2014
Footnotes
The authors report the following potential conflict of interest or source of funding: B.G.D. receives support from American Hip Institute (AHI). Board member and research support. Arthrex. Research support to AHI/consulting/royalties. MAKO Surgical and Pacira. Research support to AHI/consulting. Breg and ATI. Research support to AHI. Stryker. Stock owned. Orthomerica and DJO Global. Royalties.
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
