Summary

This study collected survivorship and patient-reported outcome scores (PROs) at minimum ten-year follow-up in patients aged = 40 years following primary hip arthroscopy with labral repair.

Abstract

Background

Arthroscopic labral repair has been shown to result in favorable short- and mid-term outcomes. Yet, the durability of outcomes in older patients remains controversial.

Purpose

To report prospectively collected survivorship and patient-reported outcome scores (PROs) at minimum ten-year follow-up in patients aged = 40 years following primary hip arthroscopy with labral repair. (2) To perform a sub-analysis comparing survivorship and outcomes for patients aged = 40 years and patients aged < 40 years.

Methods

Data were prospectively collected and retrospectively reviewed on all patients who underwent primary hip arthroscopy between February 2008 and December 2011. Patients aged = 40 years who underwent labral repair were included. Preoperative and minimum ten-year follow-up for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS) for pain were collected. Exclusion criteria were prior ipsilateral hip surgery/conditions, Tönnis grade > 1, hip dysplasia, or worker’s compensation. Propensity-score matching was utilized to compare patients aged = 40 years to patients < 40. Rates of achieving the minimal clinically importance difference (MCID), patient acceptable symptomatic state (PASS) and hip joint survival from conversion to total hip arthroplasty (THA) were reported.

Results

Of the 113 hips eligible for analysis, 91 hips (80.5%) had minimum ten-year follow-up. There were 64 females (70.3%) and 27 males (29.7%) with mean age and BMI of 47.8 years and 25.8 kg/m2, respectively. The ten-year survivorship for patients aged = 40 years was 75.8%, and there was significant improvement in all PROs and VAS from baseline to minimum ten-year follow-up. Patients achieved MCID/PASS at high rates for all PROs and VAS. Sixty-nine patients aged = 40 years were propensity matched to 107 patients < 40 years. Patients aged = 40 years demonstrated lower survivorship (78.3% vs. 91.6%), but lower rates of secondary hip arthroscopy (2.9% vs. 14.0%).

Conclusion

Patients aged = 40 years who underwent primary hip arthroscopy with labral repair demonstrated a survivorship of 75.8%, significant improvement in PROs, and achieved MCID/PASS at high rates at minimum ten-year follow-up. Sub-analysis revealed comparable PROs, but patients = 40 years demonstrated lower survivorship and lower rates of secondary hip arthroscopy compared to patients < 40 years.