AI Article Synopsis
- - The systematic review aimed to evaluate the reasons, results, and potential issues related to hip arthroscopy in patients aged 50 and older over the last five years, analyzing studies from databases like PUBMED and MEDLINE.
- - A total of 17 studies with 6,696 patients showed that most underwent surgery for unspecified reasons, with some improvement in functional outcomes, but older patients faced worse results compared to younger ones and had higher rates of needing total hip arthroplasty (THA).
- - Despite a range of complication rates (0 to 38.3%) and varying conversion rates to THA, hip arthroscopy generally resulted in significant patient-reported improvements, suggesting careful consideration of individual patient factors before proceeding with
Article Abstract
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 5 years.
Methods: The electronic databases PUBMED, MEDLINE, and EMBASE were searched on March 3, 2022, for studies assessing the use of primary hip arthroscopy for patients aged 50 years or older from the past 5 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 6,696 patients (37.5%) 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 6 studies that compared outcomes across multiple age groups, 3 demonstrated significantly worse functional outcomes, and 2 demonstrated significantly higher rates of conversion to 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 postoperatively.
Conclusions: Hip arthroscopy for patients aged 50 years or older yields significant improvements in patient-reported outcomes postoperatively 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.
Level Of Evidence: IV, systematic review of Level III and IV studies.
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| http://dx.doi.org/10.1016/j.arthro.2022.08.019 | DOI Listing |
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