Purpose
The purpose of this systematic review was to assess the indications, outcomes, and
complications of hip arthroscopy in individuals 50 years of age or older over the
past 5 years.
Methods
The electronic databases PUBMED, MEDLINE, and EMBASE were searched on March 3, 2022,
for studies assessing the use of primary hip arthroscopy for patients aged 50 years
or older from the past 5 years. The Methodological Index for Non-randomized Studies
(MINORS) was used to assess study quality. Data are presented descriptively.
Results
Overall, 17 studies were included, consisting of 6,696 patients (37.5%) with a mean
age of 61.4 ± 5.0 years and a median follow-up of 24 months (range: 1.4-70.1). Indications
for hip arthroscopy in patients aged 50 years or older were unspecified/undefined
(93.8%), mixed pathology (i.e., combined femoroacetabular impingement [FAI], labral
tear, osteoarthritis, etc.) (2.7%), and FAI (2.6%). Eleven studies demonstrated significant
improvement in functional outcome scores from baseline to final follow-up. Of the
6 studies that compared outcomes across multiple age groups, 3 demonstrated significantly
worse functional outcomes, and 2 demonstrated significantly higher rates of conversion
to THA for older patients compared to younger patients. Lastly, the overall complication
rates ranged from 0 to 38.3%. The rate of conversion to THA ranged from 0 to 34.6%,
occurring between 6 and 60 months postoperatively.
Conclusions
Hip arthroscopy for patients aged 50 years or older yields significant improvements
in patient-reported outcomes postoperatively compared to baseline, with a moderate
rate of conversion to THA (range: 0 to 34.6%). Clinicians should consider patient
history (e.g., imaging, comorbidities, etc.) and values when electing for hip arthroscopy
in the older population.
Level of Evidence
IV, systematic review of Level III and IV studies
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Article info
Publication history
Published online: August 30, 2022
Accepted:
August 5,
2022
Received:
March 22,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: M.J.P. reports personal fees from Smith & Nephew, Arthrosurface, MJP Innovations, MIS, Synthes, Siemens, Bledsoe, ConMed Linvatec, DJO, Slack, and Elsevier; he is a shareholder of Smith & Nephew, MIS, Vail Valley Surgical Center, Vail MSO Holdings, EffRx, Olatec, and iBalance (Arthrex), Stryker, Trimble, 3M, Bristol Meyers Squibb, Pfizer, AbbVie, and Johnson & Johnson; he has received grants from Smith & Nephew, Ossur, Arthrex, and Siemens; he is a board member of Vail Health Services, Vail Valley Surgical Center, International Society of Hip Arthroscopy, Orthopedics Today, and AJSM; he co-chair of the Steadman Philippon Research Institute, and investor in Manna Tree Partners, outside the submitted work. O.A. is an educational consultant for the Speakers Bureau of ConMed. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
