ePoster #745 - ISHA Annual Scientific Meeting 2016

Hip Arthroscopy Results in Improved Patient Reported Outcomes Compared to Non-Operative Management

Luke Spencer-Gardner, MD, Dallas, TX UNITED STATES
Amir Kalanie, FRACS, Sydney AUSTRALIA
Parminder J. Singh, MBBS, MRCS, FRCS (Tr & Orth), MS, Richmond, VIC AUSTRALIA
John M. O'Donnell, MBBS, FRACS, FAOrthA, Hawthorn, VIC AUSTRALIA

Hip Arthroscopy Australia, Melbourne, VIC , AUSTRALIA

FDA Status Not Applicable

Summary: Hip arthroscopy leads to significant improvements in patient reported outcomes when compared to non-operative management of intra-articular pathology of the hip at early follow up.

Abstract:
Introduction: Hip arthroscopy (HA) is an established treatment option to address intra-articular pathology of the hip. However, some clinicians encourage non-operative management (NOM) in isolation. The aim of this study is to compare the clinical outcomes of (NOM) for intra-articular hip pathology with matched controls that undergo HA. Methods: This retrospective matched-pair analysis identified all patients less than 60 years of age from a HA waiting list in the Australian public hospital system. Patient reported outcomes (PRO) were collected while an unstructured non-operative program of physiotherapy and activity modification was completed. A separate group of patients who had previously undergone HA were matched based on age, sex, body mass index and baseline non-arthritic hip scores (NAHS). The primary outcome measures were the NAHS and the modified Harris Hip Score (mHHS). Clinical improvement within each group was assessed using paired t-tests. Final outcomes between groups were assessed with student’s t-test or the Mann Whitney test when applicable. Results: There were 74 patients included in this study, with 37 patients in each group. The mean age was 37.5 years, and the mean follow up across groups was 16 months. There were no significant differences in age, sex, BMI and NAHS between groups at baseline. Median NAHS decreased from 57.5 to 50.0 in the non-operative group (p 0.05), and improved from 56.3 to 87.5 in the HA group (p < 0.001). Median mHHS scores increased from 49.3 to 49.6 in the non-operative group (p 0.91), and improved from 63.8 to 88.0 in the HA group (p < 0.001). At final follow up, median NAHS scores after HA were significantly higher than scores after NOM, 87.5 versus 50.0 respectively (p < 0.001) and median mHHS after HA were significantly higher than scores after NOM, 88.0 versus 52.0 respectively (p < 0.001). There were 2 failures in the HA group. 1 patient underwent THA, and another required revision HA. Conclusion: HA leads to significant improvements in PRO when compared to non-operative management of intra-articular pathology of the hip at early follow up. Prospective randomised studies with long term follow up are needed to add to our understanding of the role of non-operative management in the field of hip preservation.