ePoster #1200 - ISHA Annual Scientific Meeting 2016
Outcomes of Hip Arthroscopy in Patients with Previous Lumbar Spine Surgery: A Matched Pair Controlled Cohort Study with Minimum Two-Year Follow-Up
Sivashankar Chandrasekaran AUSTRALIA
Nader Darwish, BS, Chicago, IL UNITED STATES
Ashraf Darwish, MD, Westmont, IL UNITED STATES
Carlos Suarez Ahedo, MD, Mexico City, DF MEXICO
Parth Lodhia CANADA
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
American Hip Institute, Westmont, IL, UNITED STATES
FDA Status Not Applicable
Summary: Prior lumbar spine surgery does not adversely affect outcomes of hip arthroscopy at minimum two-year follow- up; while these patients have lower preoperative scores, they report a similar magnitude of improvement compared to a matched cohort of patients without prior lumbar spine surgery and rates for revision arthroscopy and conversion to THA are not significantly different between groups.
Background: The purpose of this study was to conduct a matched pair analysis to determine the effect of prior lumbar spine surgery (LSS) on clinical outcomes of hip arthroscopy.
Methods: Data was prospectively collected on all patients undergoing hip arthroscopy during the study period from April 2008 to December 2012. Patients were excluded if they had previous hip conditions or had undergone prior hip surgery. Patients in the study group (history of LSS) were matched in a one to one ratio to a control group (no history of LSS) according to age within 5 years, gender, body mass index categories, Tonnis grade and labral treatment. The following outcomes were recorded in each group: modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NASH), Hip Outcome Score Sports Specific Subscale (HOS-SSS), and Hip Outcome Score Activities of Daily Living (HOS-ADL), Visual Analogue Scale (VAS) for pain, patient satisfaction, revision hip arthroscopies and conversion to total hip arthroplasty (THA).
Results: During the study period 1405 hip arthroscopies were performed with 1017 eligible for matching. 873 (85.8%) patients had minimum two-year follow-up. Fifty-seven patients were matched in each group. Both groups demonstrated a significant improvement in PROs and VAS. The study group had a lower mean for all pre-operative PROs. There was no significant difference for post-operative mean PROs and change in PROs compared to the control group except for NAHS. Mean change in NAHS demonstrated a greater magnitude of improvement in the study group. There was no significant difference between mean VAS scores, patient satisfaction, and rates for revision arthroscopy and conversion to THA between the groups.
Conclusion: Prior LSS does not adversely affect outcomes of hip arthroscopy at minimum two-year follow- up. These patients have lower preoperative scores but have a similar magnitude of improvement compared to a matched cohort of patients without prior LSS. Rates for revision arthroscopy and conversion to THA are not significantly increased with prior LSS.