Arthritis suggests a poor prognosis after hip arthroscopy

January 6, 2010

Arthroscopy performed for hip injuries in athletes can result in substantial improvement with durable results. However, the prognosis is poor for those in whom arthritis prompts the procedure.

Arthroscopy performed for hip injuries in athletes can result in substantial improvement with durable results. However, the prognosis is poor for those in whom arthritis prompts the procedure.

Byrd and Jones conducted a 10-year follow-up on a group of 50 athletes who underwent 52 arthroscopic procedures on their hips. Fifteen of the athletes experienced symptoms during the performance of their sport activities; they were the focus of this investigation. They participated in a variety of sports, including football, tennis, basketball, and golf. They originally underwent arthroscopy because of unrelenting pain or imaging evidence of a lesion amenable to arthroscopic repair. The underlying diagnoses were chondral damage, labral tear, arthritis, avascular necrosis, a loose body, and synovitis.

Thirteen of the patients (87%) enjoyed a full return to their previous level of sports activity within 3 months of arthroscopy. However, the 5 patients with arthritis fared somewhat poorly-all needed total hip arthroplasty about 73 months after arthroscopy.

The authors suggested that making the diagnosis of arthritis before arthroscopy is important because doing so can identify patients who are unlikely to benefit from simple debridement and who might realize more enduring benefit from arthroplasty. They also noted that more work needs to be done in early recognition, injury prevention, and use of better restorative techniques.