Revision hip arthroscopy: findings and outcomes

F Winston Gwathmey, Kay S Jones, J W Thomas Byrd, F Winston Gwathmey, Kay S Jones, J W Thomas Byrd

Abstract

The purpose of this study is to report on the operative findings and the outcomes of revision hip arthroscopy. All hip arthroscopy cases are prospectively assessed with a modified Harris Hip Score (mHHS) preoperatively and postoperatively. This study consists of 190 consecutive hips (186 patients) who underwent revision arthroscopy with minimum 2-year follow-up. There were 69 males and 117 females with a mean age of 32.7 (14-64). The mean time from index to revision procedure was 24.5 months (3-146). Common diagnoses included labral tears (102) and unaddressed or residual femoroacetabular impingement (FAI) (49 cam, 11 pincer, and 20 combined). In addition to FAI correction, there were 82 labral debridements, 28 repairs/refixations, and 6 excisions of labral calcifications. Ninety-three underwent various amounts of synovectomy and 21 underwent iliopsoas release/debridement. At a mean follow-up of 46.9 months, 84.5% of patients reported symptomatic improvement. Twenty patients underwent subsequent surgery at mean of 51 months (11 repeat arthroscopy and 9 THA). Among 166 patients who had no further surgery, the mHHS had improved 27.1.8 points from a preoperative mean of 54.5 to 81.6. Patients who underwent treatment of FAI demonstrated a mean mHHS improvement of 25.7 points. Complications included two cases of transient pudendal neurapraxia, one case of transient quadriceps weakness, one case of retroperitoneal extravasation, and one case of perioperative myocardial infarction. In conclusion, for properly selected patients with persistent or recurrent symptoms following previous hip arthroscopy, revision surgery can result in favorable outcomes with an acceptably low complication rate.

Figures

Fig. 1.
Fig. 1.
Revision hip arthroscopy cases (by year). Note: Data for 2013 include cases from January to May.

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