IS HIP ARTHROSCOPY WORTHWHILE? INDICATIONS AND OUTCOMES.

Abstract

Introduction: The popularity of hip arthroscopy has lagged behind that of other joints. However surgeons are increasingly using hip arthroscopy to investigate and treat disorders such as early osteoarthritis, inflammatory arthritis, labral tears, loose bodies and paediatric hip disease.

We present the indications, intra operative findings and outcomes of patients undergoing hip arthroscopy.

Methods: Prospective study of 43 patients from 2000 to 2005 undergone hip arthroscopy performed by the senior author. Pre & post operative visual analogue scores and oxford hip scores were recorded.

CT or MRI was performed were clinically indicated. Mean follow up 4 months, range(2– 10).

Results: 45 hips. 20 right. 21 left. 2 bilateral. 22 females. 21 males. Mean age 39.6yrs, Range 20–65yrs

Symptoms: Pain, Clicking, Giving way.

History: Idiopathic pain 30, DDH 5, Perthes 3, Trauma acetabulum fracture 2, RT A Dislocation 1, SUFE 1, Non union 1.

6 patients had pre-op CT scans and 22 had MRI.

MRI Findings: 3 loose bodies, 14 labral tears, 2 large filling defects, 3 normal MRI

42 Arthroscopic debridement and wash outs, 3 failed scopes.

Intra operative findings: 5 loose bodies, 4 degenerate labrum’s, 10 labral tears, 14 Grade 3–4 Osteoarthritic changes, 7 Torn ligament Teres,1 normal joint.

3 normal MRI findings had labral tears and articular cartilage defects.

• Mean Pre-op VAS- 7.9 Range(5– 10). Mean Post-op VAS- 4.7 Range(1– 10)

• Mean Pre-op Oxford Hip score – 39.4 Range(27–53)

• Mean Post-op Oxford Hip Score – 25.2 Range(12–51)

• Patient Satisfaction score – 7.3 Range(1–10)

• 1 Superficial wound infection, settled with antibiotics.

Discussion: Hip arthroscopy is of value in assessing and treating patients with hip pain of uncertain cause. Our results indicated good patient satisfaction and outcomes with improved pain and Oxford hip scores. However patient selection and diagnostic expertise are critical to successful outcomes.