Search for


search for




 

Current concept of hip arthroscopy in patients with osteoarthritis: is it effective as a hip preservation surgery?
Arthrosc Orthop Sports Med 2024;11:1-5
Published online May 1, 2024;  https://doi.org/10.14517/aosm24002
© 2024 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Jae Hyeok Cheon, Chan Young Lee, Kyung-Soon Park

Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
Correspondence to: Kyung-Soon Park, https://orcid.org/0000-0002-5036-1803
Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, 322 Seoyang-ro, Hwasun-eup, Hwasun 58128, Korea. Tel: +82-62-379-7676, Fax: +82-62-379-7681, E-mail: chiasma@hanmail.net
Received April 6, 2024; Revised April 12, 2024; Accepted April 12, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Hip osteoarthritis (OA) poses as challenge in determining the efficacy and indications for hip arthroscopy. Although joint-preserving procedures are commonly employed for low-grade OA, such as OA accompanying femoroacetabular impingement or labral tear accompanying dysplasia, an optimal management strategy has not yet been established. Studies have reported varied outcomes after hip arthroscopy in patients with OA, with some reporting higher rates of total hip arthroplasty conversion, emphasizing the importance of patient selection. Factors such as the Tönnis grade, joint space narrowing, age, and impingement type have been implicated as prognostic indicators. However, evidence regarding the effectiveness of arthroscopy for higher-grade OA remains conflicting. Labral management in OA is complex, with limited research on optimal treatment strategies. The scarcity of prospective studies and conflicting results underscore the need for further research to establish clearer guidelines on hip arthroscopy for OA.
Keywords : Hip osteoarthritis; Arthroscopy; Femoroacetabular impingement
References
  1. Burman MS. Arthroscopy or the direct visualization of joints: an experimental cadaver study. JBJS 1931;13:669-95.
  2. Takagi K. The classic. Arthroscope. Kenji Takagi. J. Jap. Orthop. Assoc., 1939. Clin Orthop Relat Res 1982;167:6-8.
    CrossRef
  3. Sivasundaram L, Rice MW, Horner NS, Alter TD, Ephron CG, Nho SJ. Hip arthroscopy for the treatment of femoroacetabular impingement syndrome in hips with mild osteoarthritis (Tönnis grade 1): a matched comparative cohort analysis at minimum 5-year follow-up. Am J Sports Med 2022;50:2598-605.
    Pubmed CrossRef
  4. Martin SD, Abraham PF, Varady NH, et al. Hip arthroscopy versus physical therapy for the treatment of symptomatic acetabular labral tears in patients older than 40 years: a randomized controlled trial. Am J Sports Med 2021;49:1199-208.
    Pubmed CrossRef
  5. Palmer AJR, Ayyar Gupta V, Fernquest S, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial. BMJ 2019;364:l185.
    Pubmed KoreaMed CrossRef
  6. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet 2018;391:2225-35.
    Pubmed CrossRef
  7. Husen M, Leland DP, Melugin HP, et al. Progression of osteoarthritis at long-term follow-up in patients treated for symptomatic femoroacetabular impingement with hip arthroscopy compared with nonsurgically treated patients. Am J Sports Med 2023;51: 2986-95.
    Pubmed CrossRef
  8. Malahias MA, Gu A, Richardson SS, De Martino I, Sculco PK, McLawhorn AS. Hip arthroscopy for hip osteoarthritis is associated with increased risk for revision after total hip arthroplasty. Hip Int 2021;31:656-62.
    Pubmed CrossRef
  9. Domb BG, Gui C, Lodhia P. How much arthritis is too much for hip arthroscopy: a systematic review. Arthroscopy 2015;31:520-9.
    Pubmed CrossRef
  10. Chandrasekaran S, Darwish N, Gui C, Lodhia P, Suarez-Ahedo C, Domb BG. Outcomes of hip arthroscopy in patients with Tönnis grade-2 osteoarthritis at a mean 2-year follow-up: evaluation using a matched-pair analysis with Tönnis grade-0 and grade-1 cohorts. J Bone Joint Surg Am 2016;98:973-82.
    Pubmed CrossRef
  11. Kemp JL, MacDonald D, Collins NJ, Hatton AL, Crossley KM. Hip arthroscopy in the setting of hip osteoarthritis: systematic review of outcomes and progression to hip arthroplasty. Clin Orthop Relat Res 2015;473:1055-73.
    Pubmed KoreaMed CrossRef
  12. Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br 2009;91:16-23.
    Pubmed CrossRef
  13. Schairer WW, Nwachukwu BU, McCormick F, Lyman S, Mayman D. Use of hip arthroscopy and risk of conversion to total hip arthroplasty: a population-based analysis. Arthroscopy 2016;32:587-93.
    Pubmed CrossRef
  14. McCarthy JC, Jarrett BT, Ojeifo O, Lee JA, Bragdon CR. What factors influence long-term survivorship after hip arthroscopy? Clin Orthop Relat Res 2011;469:362-71.
    Pubmed KoreaMed CrossRef
  15. Malviya A, Raza A, Jameson S, James P, Reed MR, Partington PF. Complications and survival analyses of hip arthroscopies performed in the national health service in England: a review of 6,395 cases. Arthroscopy 2015;31:836-42.
    Pubmed CrossRef
  16. Kester BS, Capogna B, Mahure SA, Ryan MK, Mollon B, Youm T. Independent risk factors for revision surgery or conversion to total hip arthroplasty after hip arthroscopy: a review of a large statewide database from 2011 to 2012. Arthroscopy 2018;34: 464-70.
    Pubmed CrossRef
  17. Philippon MJ, Schroder E Souza BG, Briggs KK. Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older. Arthroscopy 2012;28:59-65.
    Pubmed CrossRef
  18. Giordano BD, Kuhns BD, Perets I, Yuen L, Domb BG. Acetabular morphologic characteristics predict early conversion to arthroplasty after isolated hip arthroscopy for femoroacetabular impingement. Am J Sports Med 2020;48:188-96.
    Pubmed CrossRef
  19. Nakashima H, Utsunomiya H, Kanezaki S, et al. Is arthroscopic hip labral repair/reconstruction surgery effective for treating femoroacetabular impingement in the presence of osteoarthritis? Clin J Sport Med 2021;31:367-73.
    Pubmed CrossRef
  20. Comba F, Yacuzzi C, Ali PJ, Zanotti G, Buttaro M, Piccaluga F. Joint preservation after hip arthroscopy in patients with FAI. Prospective analysis with a minimum follow-up of seven years. Muscles Ligaments Tendons J 2016;6:317-23.
    Pubmed KoreaMed CrossRef
  21. Beals TR, Soares RW, Briggs KK, Day HK, Philippon MJ. Ten-year outcomes after hip arthroscopy in patients with femoroacetabular impingement and borderline dysplasia. Am J Sports Med 2022;50:739-45.
    Pubmed CrossRef
  22. Byrd JWT, Jones KS, Bardowski EA. Influence of Tönnis grade on outcomes of arthroscopy for FAI in athletes: a comparative analysis. J Hip Preserv Surg 2018;5:162-5.
    Pubmed KoreaMed CrossRef
  23. Byrd JWT, Bardowski EA, Jones KS. Influence of Tönnis grade on outcomes of arthroscopic management of symptomatic femoroacetabular impingement. Arthroscopy 2018;34:2353-6.
    Pubmed CrossRef
  24. Crawford MJ, Dy CJ, Alexander JW, et al. The 2007 Frank Stinchfield Award. The biomechanics of the hip labrum and the stability of the hip. Clin Orthop Relat Res 2007;465:16-22.
    Pubmed CrossRef
  25. Ferguson SJ, Bryant JT, Ganz R, Ito K. An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech 2003;36:171-8.
    Pubmed CrossRef
  26. Lamba A, Boos AM, Okoroha KR, et al. Isolated arthroscopic debridement of acetabular labral tears: high rates of failure and conversion to total hip arthroplasty at 13-year minimum follow-up. Am J Sports Med 2024;52:18-23.
    Pubmed CrossRef
  27. Wolff AB, Grossman J. Management of the acetabular labrum. Clin Sports Med 2016;35:345-60.
    Pubmed CrossRef
  28. McCormick F, Nwachukwu BU, Alpaugh K, Martin SD. Predictors of hip arthroscopy outcomes for labral tears at minimum 2-year follow-up: the influence of age and arthritis. Arthroscopy 2012; 28:1359-64.
    Pubmed CrossRef
  29. Kucharik MP, Abraham PF, Nazal MR, et al. Arthroscopic acetabular labral repair versus labral debridement: long-term survivorship and functional outcomes. Orthop J Sports Med 2022;10:23259671221109012.
    Pubmed KoreaMed CrossRef
  30. Perets I, Chaharbakhshi EO, Mu B, et al. Hip arthroscopy in patients ages 50 years or older: minimum 5-year outcomes, survivorship, and risk factors for conversion to total hip replacement. Arthroscopy 2018;34:3001-9.
    Pubmed CrossRef
  31. Sunil Kumar KH, Garner M, Khanduja V. An evidence-based update on the management of articular cartilage defects in the hip. J Clin Orthop Trauma 2022;28:101830.
    Pubmed KoreaMed CrossRef
  32. Akhtar M, Wen J, Razick D, et al. Outcomes of arthroscopic joint preservation techniques for chondral lesions in the hip: an updated systematic review. Arthroscopy 2023 Nov 29 [Epub]. https://doi.org/10.1016/j.arthro.2023.11.019
    Pubmed CrossRef

May 2024, 11 (1)
Full Text(PDF) Free

Social Network Service
Services