Purpose
The purpose of this systematic review was to assess the indications, outcomes and complications of hip arthroscopy in individuals 50 years of age or older over the past five years.
Methods
The electronic databases PUBMED, MEDLINE, and EMBASE) were searched on March 3rd, 2022, for studies assessing the use of primary hip arthroscopy for patients aged 50 years or older from the past five years. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Data are presented descriptively.
Results
Overall, 17 studies were included, consisting of 6696 patients (37.5% male) with a mean age of 61.4 ± 5.0 years and a median follow-up of 24 months (range, 1.4-70.1) Indications for hip arthroscopy in patients aged 50 years or older were unspecified/undefined (93.8%), mixed pathology (i.e., combined femoroacetabular impingement [FAI], labral tear, osteoarthritis, etc.) (2.7%), and FAI (2.6%). Eleven studies demonstrated significant improvement in functional outcome scores from baseline to final follow-up. Of the six studies that compared outcomes across multiple age groups, three demonstrated significantly worse functional outcomes and two demonstrated significantly higher rates of conversion to total hip arthroplasty (THA) for older patients compared to younger patients. Lastly, the overall complication rates ranged from 0 to 38.3%. The rate of conversion to THA ranged from 0 to 34.6%, occurring between 6 and 60 months post-operatively.
Conclusion
Hip arthroscopy for patients aged 50 years or older yields significant improvements in patient-reported outcomes post-operatively compared to baseline, with a moderate rate of conversion to THA (range, 0 to 34.6%). Clinicians should consider patient history (e.g., imaging, comorbidities, etc.,) and values when electing for hip arthroscopy in the older population.