Arthroscopic hip surgery increases in popularity
The popularity of arthroscopic hip surgery has increased in recent years, with a more than 600% increase between 2006 and 2010 in the United States. But although the minimally invasive procedure, often performed on an outpatient basis, may be preferred, a recent study published in Arthroscopy: The Journal of Arthroscopic and Related Surgery found that it may not be the best option for older patients or those with arthritis.
Researchers at the Hospital for Special Surgery in New York City looked at more than 7,000 arthroscopies in California and Florida with two years follow-up. Dr. David Mayman, an orthopedic surgeon at HSS and senior study author said "One of the goals of our study was to determine the proper indications for arthroscopy. We found that a lot of arthroscopy was being done in people in whom the indications were not sound." In a summary of the study in MedicalXpress, the researchers commented that "...hip arthroscopy by an experienced orthopedic surgeon is an excellent procedure to treat hip impingement, labral tears and loose cartilage in the hip joint causing symptoms, according to the researchers. It is often performed in younger patients with the hope of relieving their symptoms and lowering their risk of future hip arthritis. Most studies to date have looked at arthroscopic hip surgery in this patient population, finding good results overall."
This study, however, looked at a wider range of ages and conditions in patients who received arthroscopies, and while they found that only 3% of patients younger than 40 had to have a hip replacement within two years of their surgery, that number increased significantly with age. 35% of patients who were 60 to 69 required a hip replacement in that same time frame. Both arthritis and obesity were also found to be major risk factors that pre-disposed patients towards needing a hip replacement within the two year period studied. "There is growing concern regarding the efficacy of hip arthroscopy in patients with pre-existing hip arthritis," Dr. Schairer, the study's lead author, said. "Previous smaller studies have also noted a worse prognosis in these patients, with most advising against hip arthroscopy in patients with more than mild arthritis. This is important information for patients and surgeons so they can have a real discussion about what about what types of treatments would be most beneficial in the long run based on a patient's individual circumstances." "Hip arthroscopy is a very good procedure in the right patient. It's a major advance in treating certain hip conditions, but not hip arthritis," Dr. Mayman said.