Abstract
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 five years.
Methods
The electronic databases PUBMED, MEDLINE, and EMBASE) were searched on March 3rd,
2022, for studies assessing the use of primary hip arthroscopy for patients aged 50
years or older from the past five 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 6696 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
six studies that compared outcomes across multiple age groups, three demonstrated
significantly worse functional outcomes and two 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 post-operatively.
Conclusions
Hip arthroscopy for patients aged 50 years or older yields significant improvements
in patient-reported outcomes post-operatively 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.
Keywords
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Article Info
Publication History
Accepted:
August 5,
2022
Received:
March 22,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Conflicts of Interest
ORA is an educational consultant for the Speaker's Bureau of ConMed.
Level of Evidence: IV, systematic review of level III-IV studies
Identification
Copyright
© 2022 Published by Elsevier on behalf of the Arthroscopy Association of North America
