ePoster #1205 - ISHA Annual Scientific Meeting 2016

Risk Factors For Conversion To Total Hip Arthroplasty Following Hip Arthroscopy

John M. Redmond, MD, Westmont, IL UNITED STATES
Asheesh Gupta, MD, Woodridge, VA UNITED STATES
Jacob Worsham, MD, Jacksonville, FL UNITED STATES
Kevin F Dunne, BS, Westmont, IL UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Westmont, IL, UNITED STATES

FDA Status Not Applicable

Summary: Multiple risk factors have been identified as possible preoperative and intraoperative risk factors for conversion to THA following hip arthroscopy.

Abstract:
Purpose: The most common reason for reoperation following arthroscopic hip surgery is conversion to total hip arthroplasty (THA). Failure of hip preservation to alleviate symptoms potentially subjects the patient to reoperation; leading the patient to a prolonged and frustrating recovery, and wastes economic resources. The purpose of this study was to identify clinical and radiographic risk factors for early conversion to THA following hip arthroscopy. Description of Methods: Data was prospectively collected on all patients treated with hip arthroscopy from January 2009 through December 2011. Inclusion criteria for the study group were patients undergoing hip arthroscopy for a labral tear, who eventually converted to total hip arthroplasty. Patients were then compared to a control group of patients who underwent hip arthroscopy for a labral tear and did not convert to total hip during the same study period. A bivariate and multivariate regression analysis of 41 preoperative and intraoperative variables was performed. Using the results of the multivariate regression we developed a simplified calculator that may be helpful in counseling a patient on the risk of conversion to THA following hip arthroscopy Summary of Methods: A total of 792 patients met inclusion and exclusion criteria. A total of 72 (9%) patients converted to THA during the follow up period. The control group consisted of 720 patients who did not convert to THA. Mean follow up was 31.1 ± 8.1 months. Mean age was 49.0 in the group that was converted to THA, compared to 37.2 in the control group. Variables simultaneously associated with conversion to THA in this model were higher age, lower preoperative modified Harris Hip Score (mHHS), decreased femoral anteversion, revision surgery, femoral outerbridge grade 2-4, performance of acetabuloplasty, and lack of performance of femoral osteoplasty. Lateral center edge angle (LCEA) has a quadratic effect, unlike other variables, and was associated with conversion the THA at lower and higher values. Utilizing these eight variables a Harrell C statistic of 0.838 was obtained. Conclusion: Multiple risk factors have been identified as possible preoperative and intraoperative risk factors for conversion to THA following hip arthroscopy. The clinician and patient should be aware of variables that may portend a poor prognosis to avoid reoperation.