ePoster #728 - ISHA Annual Scientific Meeting 2016

Are Short-Term Outcomes Of Hip Arthroscopy In Patients Older Than 55 Years Inferior To Younger Patients?

Andrew John Bryan, MD, Rochester, MN UNITED STATES
Aaron J. Krych, MD, Rochester, MN UNITED STATES
Ayoosh Pareek, BS, Rochester, MN UNITED STATES
Patrick J Reardon, BS, Rochester, MN UNITED STATES
Rebecca Berardelli, BS, Rochester, MN UNITED STATES
Nick R Johnson, BS, Rochester, MN UNITED STATES
Rohith Mohan, BA, Rochester, MN UNITED STATES
Bruce A. Levy, MD, Rochester, MN UNITED STATES

Mayo Clinic, Rochester, MN, UNITED STATES

FDA Status Not Applicable

Summary: Patient reported outcomes following hip arthroscopy are better in younger patients, however older patients do benefit from the procedure in the short-term.

Abstract:
Background: Hip arthroscopy for young patients with femoroacetabular impingement (FAI) has been successful, but the efficacy of hip arthroscopy in older patients is not clearly defined. Purpose: To evaluate the clinical outcomes of patients older than 55 years of age undergoing hip arthroscopy and compare the outcomes to patients younger than 55 years of age. Study Design: Case Series; Level of evidence, 4. Methods: 201 (63M:138F) patients undergoing primary hip arthroscopy for FAI without radiographic arthritis (Tonnis grade < 3) were isolated from a prospective database and stratified by age to an under 55-years old group and 55-years or older group. Patients were evaluated pre-operatively, 1 year and 2 years post-operatively using Modified Harris Hip Scores (MHHS) and Hip Outcome Scores (Functional scores and ADL/Sport subsets). A Wilcoxon signed rank sum test was used to evaluate the differences between the cohorts’ outcome scores at each interval. Results: The under 55 group included 174 patients (mean age 37+/-12), and the 55 and older group included 27 patients (mean age 61+/-5). Minimum follow-up time was two years in each group. Preoperative Tonnis grades and MHHS scores (59 vs. 59; p=0.75) were similar between groups. The 55 and older cohort underwent labral debridement more frequently (78% vs. 36%; p=0.02) and were more likely to have full thickness cartilage defects (22% vs. 4%; p=0.04). Despite this, both groups improved significantly from baseline MHHS, without differences at 1 (86 vs. 81; p=.53) and 2 years (73.88 vs. 79.54; p=0.06). However, at a minimum of 2 years follow up, patients younger than 55 had significant improvements over patients older than 55 in HOS subgroups for ADL score (85.6 vs 75.2; p=0.03), ADL Rating (80.1 vs 70.0; p=0.004), Sport Score (70.2 vs 55.6; p=0.04) and Sport Rating (70.2 vs 58.0; p=0.04). Conclusion: Although younger patients had superior HOS outcomes reported at 2 years compared to their older counterparts after hip arthroscopy for FAI, both groups had significant improvement compared to their baseline. These data suggest that patients older than 55 years of age without radiographic arthritis may benefit from hip arthroscopy.