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Hip

TEN YEARS AFTER: HAS OPEN HIP DISLOCATION SURGERY BEEN WORTHWHILE?

The British Hip Society (BHS)



Abstract

Introduction

Open hip debridement surgery has been used for treatment of femoral acetabular impingement pain for over ten years in our unit. While literature has reported promising short term outcomes, longer term outcomes are more sparsely reported. We aim to assess survivorship and functional outcome at ten years, in patients who have undergone open hip debridement.

Patients/Materials & Methods

All patients who had undergone open debridement surgery were identified on our database. The electronic, radiographic and paper records were reviewed. Demographic data, radiological and operative findings were recorded. All patients underwent ten year review with a standardised AP hips radiograph, questionnaire, non-arthritic hip score (NAHS), oxford hip score (OHS) and SF12 score.

Results

A total of 1626 operations were identified of which 37 had reached the tenth anniversary of their surgery. There were 14 females and 22 males. The average age was 41. 10 (45%) had undergone subsequent hip arthroplasty. Those who underwent hip arthroplasty were older at initial surgery than those who survived. However, this was not statistically significant (p= 0.127). Those who failed had a higher Tonnis and UCLA grade at time of surgery. The majority failed within the first 2 years. In those whose hip survived, the average NAHS was 87. 100% of survivors deemed there surgery to have been worthwhile.

Discussion

These results represent the first cohort of our patients to reach ten year follow up. The results represent a learning curve in patient selection. It is unsurprising that those with more arthritic change were more likely to fail.

Conclusion

In patients with clearly defined CAM impingement without joint space narrowing, open hip debridement remains an operation with worthwhile outcomes at ten years.