Minimum 10-Year Survivorship and Outcomes of Arthroscopic Treatment of Hip Labral Tears in Young Adults

Abstract

Background:

Previous studies have shown good mid-term outcomes of hip labral tear treatment with arthroscopy. However, long-term results are limited within the young adult population.

Purpose:

To report survivorship and patient-reported outcome measures (PROMs) at a minimum 10-year follow-up in young adult patients after primary hip arthroscopy with labral repair or debridement.

Study Design:

Case Series; Level of evidence, 4.

Methods:

Data were prospectively collected and retrospectively reviewed on all patients who underwent primary hip arthroscopy between June 2008 and August 2012. Young adult patients, aged >19 and <40 years, who underwent labral debridement repair or reconstruction and concomitant procedures were included. Preoperative and minimum 10-year follow-up data for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), iHOT-12 (International Hip Outcome Tool), and visual analog scale for pain (VAS–Pain) were collected. The exclusion criteria were previous ipsilateral hip surgery/conditions, Tönnis grade >1, hip dysplasia, workers’ compensation status, or femoral head and acetabular Outerbridge scores of 4. Rates of achieving the minimal clinically important difference (MCID) and the patient acceptable symptomatic state (PASS), as well as hip joint survival from conversion to total hip arthroplasty and progression to subsequent ipsilateral revision hip arthroscopy, were reported.

Results:

Of the 241 hips eligible for analysis, 194 hips (80.5%) had a minimum 10-year follow-up. A total of 122 women (62.9%) and 72 men (37.1%) were included in the present analysis, with a mean age of 28.9 years and a mean body mass index of 24.8 kg/m². The 10-year survivorship for young adult patients was 91.8%, and 12.9% of patients underwent subsequent ipsilateral arthroscopy at a mean of 36.8 months after the initial procedure. Significant improvements were observed in all PROMs from baseline to a minimum 10-year follow-up—including the mHHS, NAHS, HOS-SSS, VAS–Pain, iHOT-12, and patient satisfaction (P < .05). Patients aged 19 to 40 years achieved high rates of MCID, for mHHS, NAHS, and VAS–Pain, as well as high rates of PASS for the mHHS.

Conclusion:

Young adults who underwent primary hip arthroscopy with labral treatment demonstrated an overall 10-year survivorship of 91.8%, significant improvements in PROMs, and high achievement rates of PASS for the mHHS and MCID for the mHHS, NAHS, and VAS–Pain.