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It stands to reason that if a patient is in their 50s and leads a moderately active lifestyle, hip arthroscopy may provide the relief they require to continue those activities for a few years longer [ 35 ], but they must understand the significant risk of their decision.

All the recent work into outcomes of hip arthroscopy has shown us when to use caution. Patients with signs on AP radiographs of morphological abnormalities, particularly the presence of posterior wall sign and reduced medial proximal femoral angle, also have increased odds of arthritic progression [ 19 ].

What to Expect

These factors serve to help with deciding surgical treatment options and curb patient expectations. There are studies that support the use of arthroscopy even in the face of OA, but even some of these show a high reoperation rate and progression to THR [ 25 , 27 , 33 , 36 ]. The basis of decision-making should be formed upon a discussion with the patient regarding their expectation of hip arthroscopy and their understanding of the lengthy rehabilitation process that may ensue following arthroscopic intervention.

Discussion must also emphasize the possible finding of arthritis at the time of procedure even if there are minimal radiographic signs pre-operatively. The goals of treatment do change in the over 40s and in those with recognizable OA. With many studies showing a high conversion rate within a short period following arthroscopy, perhaps in the face of moderate arthritis, arthroscopy cannot delay the need for hip arthroplasty.

National Center for Biotechnology Information , U. J Hip Preserv Surg. Published online Feb Viswanath and V. Author information Article notes Copyright and License information Disclaimer. Corresponding author. E-mail: ku. Received Nov 10; Accepted Nov Published by Oxford University Press.

For commercial re-use, please contact journals. This article has been cited by other articles in PMC. Abstract Hip arthroscopy for joint preservation surgery has grown immensely over the last two decades. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res ; — Alshameeri Z, Khanduja V.

The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint. International Orthopaedics ; 38 8 — Imam S, Khanduja V. Current concepts in the diagnosis and management of femoroacetabular impingement. International Orthopaedics ; 35 10 — Murray RO. The aetiology of primary osteoarthritis of the hip. Br J Radiol ; 38 — Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res ; 20— Computed tomography assessment of hip joints in asymptomatic individuals in relation to femoroacetabular impingement.

Risks of Hip Arthroscopy

Am J Sports Med ; 38 —5. Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am ; 92 — The prevalence of cam-type deformity of the hip joint: a survey of subjects of the Copenhagen Osteoarthritis Study. Acta Radiol ; 49 — Complications and survival analyses of hip arthroscopies performed in the national health service in England: a review of 6, cases. Arthroscopy ; 31 — Arthroscopic hip preservation surgery: current concepts and perspective. Bone Joint J ; B 1 —9. Griffiths EJ, Khanduja V.

Hip arthroscopy: evolution, current practice and future developments. Int Orthop ; 36 6 — Khanduja V, Villar RN. Arthroscopic surgery of the hip: current concepts and recent advances.

Hip Arthroscopy and Hip Joint Preservation Surgery

J Bone Joint Surg Br ; 88 12 — Does femoroacetabular impingement contribute to the development of hip osteoarthritis? A systematic review. Sports Med Arthrosc ; 23 —9. Is prophylactic surgery for femoroacetabular impingement indicated? Am J Sports Med ; 42 — J Bone Joint Surg Am ; 93 : e — Leunig M, Ganz R. A common cause of hip complaints leading to arthrosis]. Unfallchirurg ; :9— Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of healthy young adults. Radiology ; — Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study CHECK.

Osteoarthritis Cartilage ; 21 — Predictors of progression of osteoarthritis in femoroacetabular impingement: a radiological study with a minimum of ten years follow-up. J Bone Joint Surg Br ; 91 —9. Differences in anatomical parameters between the affected and unaffected hip in patients with bilateral cam-type deformities. Clin Biomech Bristol, Avon ; 33 —9. Hip arthroscopy for femoroacetabular impingement in patients aged 50 years or older. Arthroscopy ; 28 — Joint space predicts THA after hip arthroscopy in patients 50 years and older.

Clin Orthop Relat Res ; —6. Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res ; —9. Does femoral rotation influence anteroposterior alpha angle, lateral center-edge angle, and medial proximal femoral angle?

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A pilot study. Aufranc award: the role of labral lesions to development of early degenerative hip disease. A preliminary report on prevalence of acetabular labrum tears in sports patients with groin pain. Knee Surg Sports Traumatol Arthrosc ; 11 —8. Outcomes of hip arthroscopy in patients aged 50 years or older compared with a matched-pair control of patients aged 30 years or younger. Arthroscopy ; 31 —8. Clinical and functional outcome after acetabular labral repair in patients aged older than 50 years.

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Arthroscopy ; 30 — Predictors of hip arthroscopy outcomes for labral tears at minimum 2-year follow-up: the influence of age and arthritis. Outerbridge RE. The etiology of chondromalacia patellae. How much arthritis is too much for hip arthroscopy: a systematic review. Arthroscopy ; 31 —9. Hip arthroscopy in the setting of hip osteoarthritis: systematic review of outcomes and progression to hip arthroplasty.

Haviv B, O'Donnell J. The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients. Arthroscopic management of protrusio acetabuli.

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Can hip arthroscopy in the presence of arthritis delay the need for hip arthroplasty?

Arthroscopy ; 29 — Hip arthroscopy: indications and technical pearls. Clin Orthop Relat Res ; —7. Outcome of arthroscopy in patients with advanced osteoarthritis of the hip. PloS One ; 10 :e Femoroacetabular impingement treatment using arthroscopy and anterior approach. Arthroscopic treatment of labral tears in femoroacetabular impingement: a comparative study of refixation and resection with a minimum two-year follow-up.

J Bone Joint Surg Br ; 93 — Create Alert. Share This Paper. Figures, Tables, and Topics from this paper. Figures and Tables. Citations Publications citing this paper. Flores , Caitlin C. Chambers , Kristina R. Borak , Alan L. Good midterm results of hip arthroscopy for femoroacetabular impingement. Osteoarthritis of the hip and knee in former male professional soccer players. References Publications referenced by this paper. Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment.