Summary

The MASH Study Group's updated analysis of 7,570 hip arthroscopy patients shows trends in demographics, diagnoses, and treatments, highlighting labral tears as the most common issue in predominantly younger female patients.

Abstract

As hip arthroscopy continues to rapidly advance, our understanding of the demographics of patients undergoing this procedure have led to improved diagnoses and treatment strategies. The Multicenter Arthroscopic Study of the Hip (MASH) Study Group conducts multicenter clinical studies in arthroscopic hip preservation surgery. Patients undergoing arthroscopic hip preservation surgery are enrolled in a large prospective longitudinal cohort at 12 separate sites nationwide by 12 fellowship-trained hip arthroscopy surgeons. It has been 7 years since our pilot study analyzing epidemiologic data on 1738 patients enrolled between January 2014 and November 2016. These data include demographics, pathologic entities treated, patient-reported measures of disease, and surgical treatment preferences. This study provides an update to the 2017 Multicenter Arthroscopic Study of the Hip (MASH) Study Group pilot study to demonstrate trends in hip arthroscopy patient demographics, intraoperative findings, patient outcomes, and future goals from perspective of a large multicenter hip arthroscopy group.
In our analysis, from January 2014 and December 2023, we enrolled 7,570 patients (4,294 females, 2,139 males, and 1,134 unknown) into the registry, more than 4 times as many patients than the pilot study. Our study results showed that most commonly, patients who elected hip arthroscopy were younger to middle-aged females with pain primarily located in the anterior hip or groin region. Most had pain for at least four months, and it was commonly exacerbated by sitting and athletic activities. Patients reported clinically significant pain and functional limitation and a decrease in physical and mental health. It was not uncommon for patients to have undergone another, related surgery and nonoperative treatments, including intra-articular injection and/or physical therapy, before surgery. Pre-operatively, there was a high incidence of abnormal hip morphology suggestive of a cam and/or pincer lesion, and the incidence of articular cartilage injury was high. Labral tear was the most common diagnosis, and most often it was addressed with repair. Many patients underwent femoroplasty, synovectomy, acetabuloplasty, and chondroplasty in addition to labral repair. The most significant differences from the 2017 MASH report are the reduction of isolated pincer impingement treated with surgery, improved patient reported outcomes at time of surgery, and an increase in mechanical symptoms reported prior to surgery.