What factors influence long-term survivorship after hip arthroscopy?

Clin Orthop Relat Res. 2011 Feb;469(2):362-71. doi: 10.1007/s11999-010-1559-2.


Background: Hip arthroscopy is an evolving procedure. One small study suggested that a low modified Harris hip score and arthritis at the time of surgery were predictors of poor prognosis.

Questions/purposes: We therefore intended to confirm those findings with a large patient cohort to (1) determine the long-term nonarthritic hip score; (2) determine survivorship; (3) identify risk factors that increase the likelihood of THA; and (4) use those factors to create a usable risk assessment algorithm.

Patients and methods: We retrospectively reviewed 324 patients (340 hips) who underwent arthroscopy for pain and/or catching. Of these, 106 patients (111 hips or 33%) had a minimum followup of 10 years (mean, 13 years; range, 10-20 years). The average age was 39 years (± 13) with 47 men and 59 women. We recorded patient age, gender, acetabular and femoral Outerbridge grade at surgery, and the presence of a labral tear. Followup consisted of a nonarthritic hip score or the date of a subsequent THA. We determined survivorship with the end point of THA for the acetabular and femoral Outerbridge grades.

Results: Overall survivorship among the 111 hips was 63% at 10 years. The average nonarthritic hip score for non-THA patients was 87.3 (± 12.1). Survivorship was greater for acetabular and femoral Outerbridge grades normal through II. Age at arthroscopy and Outerbridge grades independently predicted eventual THA. Gender and the presence of a labral tear did not influence long-term survivorship.

Conclusions: The long-term survivorship of labral tears with low-grade cartilage damage indicates hip arthroscopy is reasonable for treating labral tears.

Level of evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

MeSH terms

  • Acetabulum / pathology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis / surgery*
  • Arthroplasty, Replacement, Hip*
  • Cartilage, Articular / injuries
  • Cartilage, Articular / pathology
  • Child
  • Female
  • Femur / pathology
  • Hip Joint / surgery*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prosthesis Failure
  • Range of Motion, Articular
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Young Adult