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Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA

Kelsi Greenwood, BScHons
SOUTH AFRICA

Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA

Kelsi Greenwood, BScHons, SOUTH AFRICA Jurek R. T. Pietrzak, MBBCh, FCS(SA)Orth, UNITED KINGDOM Zia Maharaj, MBChB(Pret), SOUTH AFRICA Josip N. Cakic, MD, PhD, FCS(SA)Orth, MMed(Orth)WITS, SOUTH AFRICA

Charlotte Maxeke Johannesburg Academic Hospital , Johannesburg, Gauteng, SOUTH AFRICA

2021 Congress Abstract Presentation 5 minutes rating (1)

Anatomic Location

Hip / Groin / Thigh

Anatomic Structure

Bones

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Arthroplasty Arthroscopy Total Joint Replacement

Sports Medicine

Evidence Based Medicine Outcome Studies

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Summary: A retrospective review of 898 patients revealing similar mid-term Patient Reported Outcome Measures between Index THA and THA after previous Hip Arthroscopy (HA), with higher risk of poor THA outcomes associated with multiple previous HA’s compared to a single previous HA.

Background

Whilst Total Hip Arthroplasty (THA) remains a popular and reliable operation, the number of Hip Arthroscopy (HA) procedures performed has significantly increased in frequency over the past few years. Globally today, more patients are likely to undergo THA after previous HA (Conversion THA). The impact on post-operative clinical and functional outcomes remains controversial. We, therefore, aimed to compare the Patient-Reported Outcomes Measures (PROMs), satisfcation rates and complication rates after Conversion THA (>1 previous HA) with patients after Index THA (No previous HA).

Methods

We performed a retrospective case review of 898 consecutive patients for Primary THA by a high-volume surgeon with minimum 2-year follow-up using the Direct Anterior Approach. Demographic data and PROMs were recorded. All cases were assessed for complications and re-operations. Implant survival was calculated using Kaplan-Meier analysis. Statistical significance was p<0.05.

Results

This study included 804 (89.53%) patients for Index THA (mean age 56.54years; BMI 28.54kg/m2) and 94 (10.47%) for Conversion THA (mean age 47.53years; BMI 29.91kg/m2), respectively. Satisfaction rates were similar for Index and Conversion THA patients (93.78% vs. 91.49%; p=0.009). The Patient Joint Perception (PJP) scores were “Native/Natural joint” for 68.78% of Index THA patients and 63.83% for Conversion THA patients (p=0.046). The mean pain score (p=0.003), modified Harris Hip Score (mHHS) (p=0.001) and Forgotten Joint Score-12 (p<0.000) favoured Index THA over Conversion THA patients. Conversion THA patients that had a single HA were 1.2-fold more likely to have a “Native/Natural joint” PJP compared to multiple HAs before THA (OR 1.42,1.18; p=0.008). Conversion THA patients that had a single HA are 2.01-fold more likely to have an mHHS =80 compared to multiple HAs (OR 3.3,1.64; p=0.018). Surgical complication rate was 7.45% for Index THA and 8.64% for Conversion THA (p=0.004). Deep PJI incidence for Index THA was 0.50% compared to 1.06% for Conversion THA (p=0.037). Total implant survival at 3 years was 97.9% (SE 0.005; 95%CI 96.9-98.9) for Index THA and 96.6% for Conversion THA (SE 0.019; 95%CI 92.9-1.00).

Conclusion

Medium-term PROMs are similar for Conversion THA and Index THA patients. However, Conversion THA following multiple HA’s show an increased risk for poor patient clinical outcomes compared to single HA.

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Outcomes Of Revision Hip Arthroscopy Are Unaffected By Intraoperative Findings: A Matched Cohort Study ePoster Presentation Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Stem Cells Injection And Percutaneous Femoral Head Decompression - An Extremely Rare Procedure With Good Results ePoster Presentation Sofia Moura De Carvalho, MD, PORTUGAL Inês Domingues, MD, PORTUGAL Liliana Domingues, MD, PORTUGAL Eduardo Ramalho Silva, MD, PORTUGAL Gonçalo Lavareda, MD, PORTUGAL Filipe Machado, MD, PORTUGAL Rita Ricardo, MD, PORTUGAL
Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Endoscopic Shelf Acetabuloplasty Concomitant With Labral Repair, Cam Osteoplasty, And Capsular Plication For Treating Artistic Dancers In The Setting Of Acetabular Dysplasia: A Case Series Abstract Presentation 4 minutes Soshi Uchida, MD, PhD, JAPAN Yoichi Murata, MD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Tsukamoto Manabu, MD, PhD, JAPAN Akihisa Hatakeyama, MD, JAPAN Shiho Kanezaki, MD, PhD, JAPAN Akinori Sakai, MD, PhD, JAPAN
Labral Preserving Hip Arthroscopy and Bone Marrow Aspirate Injection for Patients with Symptomatic Labral Tears and Early Degenerative Changes Abstract Presentation 7 minutes Molly A Day, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Not Every Hip Impingement Requires Hip Arthroscopy. Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit from Arthroscopic Hip Surgery ePoster Presentation Benjamin Saks, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Andrew Jimenez, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy? Abstract Presentation 5 minutes Michael Peter Kucharik, BS, UNITED STATES Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Scott D Martin, MD, UNITED STATES
Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Jennifer Kurowicki, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Edward Milman, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES
Promis Validation In Hip Arthroscopy: A Shift Towards Reducing Survey Burden Abstract Presentation 4 minutes Erik Gerlach, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Daniel Johnson, MD, UNITED STATES Richard W. Nicolay, MD, UNITED STATES Gregory Versteeg, MD, UNITED STATES Mark Andrew Plantz, BS, UNITED STATES Peter Swiatek, MD, UNITED STATES Eric Sanders, MD, UNITED STATES Bejan Alvandi, MD, UNITED STATES Vehniah K. Tjong, MD, FRCSC, UNITED STATES Michael Terry, MD, UNITED STATES
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Intra-Articular Damage in Patients with FAI Undergoing Hip Arthroscopy Abstract Presentation 5 minutes Jacob Shapira, MD, UNITED STATES Jade S Owens, BS, UNITED STATES David R. Maldonado, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Bezalel Peskin, MD, ISRAEL Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics Abstract Presentation 5 minutes Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Francisco Reina, MD, PhD, SPAIN Anna Carrera, MD, PhD., SPAIN Mauricio Gidi, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Clinical Predictors of Outcome Following Proximal Hamstring Tendon Repair ePoster Presentation Heath Patrick Gould, MD, UNITED STATES William Rate, MS, MD, UNITED STATES Matthew Civilette, MD, UNITED STATES John Hamilton, MD, UNITED STATES James Dreese, MD, UNITED STATES
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Amniotic Suspension Allograft Injection For Hip Osteoarthritis: Prospective Pilot Study With 1 Year Follow Up Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Molly Claire Meadows, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Shane Nho, MD, MS, UNITED STATES
Defining Sex-Based Outcomes Following Hip Arthroscopy In Patients With Borderline Hip Dysplasia. ePoster Presentation Benjamin Saks, MD, UNITED STATES James Fox, BBA, UNITED STATES Jade S Owens, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES

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Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA

Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA

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Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA

Total Hip Arthroplasty (THA) after Previous Hip Arthroscopy: A Mid-Term Functional and Clinical Comparison with Index THA

Background

Methods

Results

Conclusion

More ISAKOS 2021: Global Content