ePoster #1501 - ISHA Annual Scientific Meeting 2016
Outcomes of Hip Arthroscopy in Adolescents: A Comparison of Acute vs. Chronic Labral Tears. Two Year Minimum Follow-Up
Lyall Ashberg, MD, Westmont, IL UNITED STATES
John P. Walsh, MA, Westmont, IL UNITED STATES
Mary R. Close, BS, Westmont, IL UNITED STATES
Itay Perets, MD, Westmont, IL UNITED STATES
Edwin Chaharbakhshi, BS, Hinsdale, IL UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
American Hip Institute, Westmont, IL, UNITED STATES
FDA Status Not Applicable
Summary: Hip arthroscopy in adolescent patients being treated for labral tears is safe and effective at 2 year follow-up; while preoperative PRO scores were lower in patients presenting acutely, there were no significant differences in final PRO scores; however, reoperation rate was significantly higher in patients with an acute presentation.
Hip arthroscopy in adolescent patients is becoming more common and has been shown to be effective in managing various hip pathologies, including labral tears. The purpose of this study was to ascertain whether or not outcomes of hip arthroscopy in patients under the age of 18 being treated for labral tears differ depending on whether the presentation was acute or chronic. We also present the outcomes of the largest prospectively collected study on hip arthroscopy performed for labral tears in adolescent patients.
Patient reported outcome scores (PROs) for patients undergoing hip arthroscopy between April 2008 and December 2013 were prospectively collected and retrospectively reviewed. Patients that were under the age of 18, treated for labral tears, and eligible for 2-year follow-up were included in the cohort, with those that had Tonnis>0, revision surgeries, and previous hip conditions excluded. The PROs collected were: modified Harris hip score (mHHS), Non-arthritic hip score (NAHS), Hip Outcome Score-Sport Specific Scale (HOS-SSS) and Visual Analogue Score (VAS). The overall cohort was assessed for outcomes and a comparison was made between patients who presented acutely and those who present in a delayed fashion. Pre-operative and post-operative PROs, as well as ?PROs between chronic and acute groups were analyzed. Normalcy was assessed using the Shapiro-Wilk Test and variance was assessed using the F-test. Data was then analyzed for significant differences using t-tests, Mann-Whitney U Tests, Welch Tests, and Chi-square analyses; p-values<0.05 were considered statistically significant.
A total of 194 patients met all the inclusion and exclusion criteria, with 157 (80%) having minimum 2-year follow-up. There was significant improvement in all of the PROs for the overall cohort, with an average follow-up of 36.9 months. The only significant differences between the acute and chronic groups found were lower pre-operative PROs and greater change in VAS for the acute group. Overall need for revision surgery was 12%, with a significantly higher rate of revision in the acute group (29%) compared to the chronic group (7.6%).
Hip arthroscopy in adolescent patients being treated for labral tears is safe and effective at 2 year follow-up. PROs are significantly improved over a minimum of 2 year follow-up. While preoperative PRO scores were lower in patients presenting acutely, there were no significant differences in final PRO scores; however, reoperation rate was significantly higher in patients with an acute presentation.