Purpose

To report midterm outcomes of hip arthroscopy in patients with pre-existing inflammatory joint diseases (IJD) and compare their outcomes to patients without IJDs.

Methods

Data was prospectively collected on all hip arthroscopies performed between February 2008 and December 2018. Patients with IJD undergoing hip arthroscopy for the treatment of femoroacetabular impingement (FAI) with labral tears were included in this study. Patients were excluded if they had previous ipsilateral hip conditions other than IJDs, dysplasia (LCEA < 18°), and Tonnis grade > 1. IJD hips with minimum five-year follow-up were matched in a 1:3 ratio to non-IJD hips based on age at surgery, sex, BMI, and Tonnis Grade. Patient reported outcomes (PROs), rates of achieving clinically relevant thresholds, and rates of secondary procedures were compared between the two groups.

Results

A total of 27 IJD hips (23 patients) were matched to a benchmark control group of 81 non-IJD hips (79 patients). At minimum 5-year follow-up both groups showed significant improvement in all PROs with similar magnitudes of improvement. The IJD group had lower postoperative PRO scores when compared to the control group and had fewer patients meet PASS for NAHS, but met MCID, SCB, and PASS for remaining PROs at similar frequencies as the control group. The IJD group had a 3.57 increased odds of a second hip surgery [odds ratio: 3.57, 95% CI 1.04-12.23, p < 0.05] and 0.14 decreased odds of arthroplasty-free survivorship [odds ratio: 0.14, 95% CI 0.04 - 0.56, p <0.01].

Conclusion

Patients with IJD undergoing hip arthroscopy had significant improvement in all PROs at minimum 5-year follow-up. However, IJDs reached lower postoperative PROs, achieved clinically significant benchmarks less frequently, had increased odds of 3.57 for revision arthroscopy, and had reduced odds of 0.14 for arthroplasty-free survivorship when compared to the benchmark control group.