2025 ISAKOS Biennial Congress ePoster
Revision Hip Arthroscopy Yields Inferior Patient Reported Outcome Measures And 2-Year Satisfaction Along With Higher Total Hip Arthroplasty Conversion Compared To The Primary Setting: A Meta-Analysis
Juan Bernardo Villarreal-Espinosa, MD, Chicago, Illinois MEXICO
Fernando Gómez Verdejo, MD, Mexico City, Mexico City MEXICO
Michael Murray, Chicago, IL UNITED STATES
Kyleen Jan, MD, Chicago, IL UNITED STATES
Amelia L Hummel, MD, Chicago, Illinois UNITED STATES
Melissa Carpenter, MD, Chicago, Illinois UNITED STATES
Udit Dave, BS, New Orleans , Louisiana UNITED STATES
Cameron Gerhold, BS UNITED STATES
Kristen I Barton, MD, PhD, London, Ontario CANADA
Jorge Chahla, MD, PhD, Hinsdale, IL UNITED STATES
Rush University Medical Center, Chicago, Illinois, UNITED STATES
FDA Status Not Applicable
Summary
Patients undergoing revision hip arthroscopy achieve inferior patient satisfaction and functional outcomes, as reflected in patient reported outcome measures and PASS achievement rates, compared to those observed in the primary setting
ePosters will be available shortly before Congress
Abstract
Background
As primary hip arthroscopy rates rise, so do revision hip arthroscopy rates. It has been reported that 2-17% of patients undergoing an initial arthroscopic procedure may require revision surgery. Debate exists as to whether revision surgery should be routinely performed.
Purpose
To compare functional and patient reported outcomes between primary and revision hip arthroscopy.
Methods
A systematic search was conducted using 3 databases (PubMed, EMBASE, CINAHL) in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Only comparative clinical studies evaluating primary versus revision hip arthroscopy with minimum 2-year follow-up were considered for inclusion. A meta-analysis was performed to evaluate patient-reported outcome measures (PROMs), clinically significant outcomes (CSOs), reoperation rates, and total hip arthroplasty (THA) conversion rates.
Results
Nine studies (level of evidence II-III) were included for analysis. In total, 2128 and 723 patients (2230 and 737 hips) were included in the primary and revision setting, respectively. Femoroacetabular impingement (FAI) and labral-related procedures were reported in all patients. There was a significantly lower Hip Outcome Score Activities of Daily Living and Sports subsection (HOS-ADL; HOS-SS) scores in patients undergoing revision hip arthroscopy (HOS-ADL: p=0.0009; HOS-SS: p=0.00001). Moreover, there were also significantly lower modified Hip Harris Score (mHHS) and International Hip Outcome Tool 12 (iHOT12) scores in the revision setting (mHHS: p=0.0001; iHOT12: p=0.00001). There was no significant difference in repeat hip arthroscopy rates (7.1% vs. 6%, p=0.86), however, a significantly increased THA conversion rate was observed in the revision cohort (3.3% vs. 8.7%, p=0.0001). Patient Acceptable Symptomatic State (PASS) threshold achievement rates were consistently higher in the primary hip arthroscopy group, yet minimal clinically important difference (MCID) achievement rates did not reveal the same superiority.
Conclusion
Patients undergoing revision hip arthroscopy achieve inferior patient satisfaction and functional outcomes, as reflected in patient reported outcome measures and PASS achievement rates, compared to those observed in the primary setting. No apparent revision arthroscopy differences were observed, however, the revision cohort was associated with higher total hip arthroplasty conversion rates.