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Propensity-Matched Patients Undergoing Revision Hip Arthroscopy Over the Age of 40 Had Higher Risk of Conversion to Total Hip Arthroplasty Compared to Their Primary Counterparts

      Abstract

      Purposes

      To report patient-reported outcomes (PROs) and survivorship following revision hip arthroscopy in patients aged ≥ 40 years and to compare these results to a propensity-matched primary hip arthroscopy control group.

      Methods

      Data were prospectively collected and retrospectively reviewed for all patients who underwent revision hip arthroscopy between June 2008 and January 2019. Patients were included if they were ≥ 40 years of age at the time of surgery and had minimum 2-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Visual Analog Scale for pain and the Hip Outcome Score-Sports Specific Subscale (HOS-SSS). Patients who had a previous hip condition, or those who lacked minimum two-year follow-up, were excluded. The revision group was further analyzed by conducting a 1:1 propensity-matched sub-analysis to a primary hip arthroscopy control group based on age, sex, body mass index (BMI), and acetabular labrum articular disruption grade. Statistical significance was set at P < .05.

      Results

      Eighty-nine hips (92.7% follow-up) were included, with 66.3% being females. The mean age, BMI, and follow-up time were 49.4 ± 8.0 years, 26.6 ± 4.1, and 62.7 ± 38.5 months, respectively. Significant improvement in all PROs (P < .001) was reported, and 71.8%, 58 74.4%, and 65.2% achieved the minimal clinically important difference (MCID) for the mHHS, NAHS, and HOS-SSS, respectively. Eighty-seven revision hips were successfully propensity-matched to 87 primary hips. Both groups reported similar improvement for all PROs, but the relative risk of THA conversion was 2.63 times higher (95% CI, 1.20 – 5.79) for the revision group.

      Conclusion

      Patients aged ≥ 40 years who underwent revision hip arthroscopy reported significant improvement in all PROs at a mean follow-up of 62.7 months with favorable rates of achieving the MCID. When compared to the propensity-matched control group, both achieved similar rates of improvement, but the revision group was 2.63 times more likely to convert to THA.
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