Largest Hip Arthroscopy Study Shows Improved Outcomes (Orthopedics This Week)
One surgeon…1,155 arthroscopies. Benjamin Domb, M.D., founder of the American Hip Institute, recently presented his clinical outcomes study at the American Orthopedic Society for Sports Medicine (AOSSM). This study represents the largest series of patients undergoing hip arthroscopy by a single surgeon. Dr. Domb tells OTW, “Hip arthroscopy is a relatively new field and is still finding its place in the world. In the first few years there was an understandable amount of skepticism about the procedure; as the field evolves, clinical data is critical to establishing its role. For this study, all of the primary and revision arthroscopies were performed from February 2008 to June 2012, and then we conducted a two-year minimum follow-up. After exclusions, we ended up with 328 men and 593 women in the study.”
“We found a statistically significant improvement in all patient reported outcomes, a decrease in patient pain and an increase in patient satisfaction. And, importantly, 94.4% of patients were able to avoid a hip replacement.”
“I generally consider hip arthroscopy for patients who don’t have any significant arthritis; it is not appropriate for patients with too much cartilage damage. We also did find that the higher the age the greater likelihood of failure.”
“We are now working on a statistical breakdown of the predictors of success, and are creating a predictive calculator to be used for prognosis and risk assessment. This will allow surgeons to use preoperative parameters to calculate the risk of conversion to hip replacement. We are also performing a logistic regression evaluation of all 41 prognostic factors in order to create a predictive model that will help surgeons refine the indications for hip arthroscopy.”
“During the early days of arthroscopy, a famous surgeon called the arthroscope ‘the tool of the devil.’ We experienced a little of that skepticism in hip arthroscopy as well over the past decade. However, we now have clinical outcomes data showing reproducible results, and hip arthroscopy is no longer the ugly stepchild of sports medicine.”