Outcome of Hip Arthroscopy: Results of The Learning Curve
Femoroacetabular impingement (FAI) may be a predisposing
factor in progression of osteoarthritis. The use of hip
arthroscopy is growing in popularity, with increasing uptake by
more orthopaedic surgeons with varying degrees of experience.
This prospective study examines the learning curve of an
arthroscopist setting up his practice.
Over a twenty month period all patients undergoing hip
arthroscopy for femoroacetabular impingement were
recorded on a prospective database. Patients were scored
pre-operatively and postoperatively at 6 months, 1 and 2
years using the non-arthritic hip score. Need for revision and
total hip arthroplasty (THR) were recorded. Data analysed
using Wilcoxon’s signed ranks test and ANOVA
Aims of Study
- Prospectively review the outcome of hip arthroscopy for FAI
- Explore the learning curve and its effect on clinical outcomes
- 120 patients, median age 39 years
- Average follow-up (F/U) 23 months.
- Median pre-operative score 58
- Overall median improvement in scores for all patients
- 6 months: 16 (CI 12 to 20, p<0.05) n= 102
- 12 months: 9 (CI 3 to 16, p<0.05) n= 63
- 24 months: 11 (CI 1 to 21, p<0.05) n= 25
- 12 progressed to THR (mean 49 weeks), 7 revision arthroscopies
- 7 minor scuffs to the femoral chondral surface on joint entry
- 3 transient parasthesia
- 1 patient with labial groin bruising.
“Learning Curve”. 3 chronological periods of
40 consecutive patients. Results for THR, revision
arthroscopy and median improvement of score.
||7 to 23
||3 to 18
||15 to 27
Cumulative % of Satisfactory Outcome:
Measured as an improvement of 10 points or
more on Non-arthritic Hip Score at 6 months.
After “settling in period” the % cumulative
satisfaction increases from 41% around the
17th procedure to 64% by the 90th procedure
- Patients see a gradual and significant improvement post hip arthroscopy, with symptoms continuing to improve until 2 years
- This is a well-tolerated procedure with a low complication rate and the opportunity for treatment of a range of hip pathology
- A learning curve exists, but a significant improvement in patient outcome is seen after the 70th procedure
- The number of revision procedures significantly reduces as the learning curve is climbed
- The need for conversion to THR is significantly reduced, probably due to improved patient selection due to improved clinical experience
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