PMID- 30301626 OWN - NLM STAT- MEDLINE DCOM- 20191007 LR - 20191007 IS - 1526-3231 (Electronic) IS - 0749-8063 (Linking) VI - 34 IP - 11 DP - 2018 Nov TI - Hip Arthroscopy in Patients Ages 50 Years or Older: Minimum 5-Year Outcomes, Survivorship, and Risk Factors for Conversion to Total Hip Replacement. PG - 3001-3009 LID - S0749-8063(18)30455-9 [pii] LID - 10.1016/j.arthro.2018.05.034 [doi] AB - PURPOSE: To report minimum 5-year outcomes and risk factors for conversion to total hip arthroplasty (THA) in patients >/=50 years old undergoing hip arthroscopy to treat labral tears and femoroacetabular impingement (FAI). METHODS: Data were prospectively collected on patients who underwent hip arthroscopy to treat labral tears and FAI between February 2008 and January 2012. The inclusion criteria were >/=50 years old at surgery, arthroscopic treatment for both labral tears and FAI, and preoperative patient-reported outcome (PRO) scores for modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS). The exclusion criteria were Tonnis grade > 1 and previous hip conditions or surgeries. RESULTS: Of 103 eligible cases, 94 hips (91.3%) had minimum 5-year follow-up at a mean of 70.1 months (range, 60.0-95.1 months). All PROs and VASs demonstrated significant improvement at latest follow-up (P = .0001). Mean patient satisfaction was 8.4. All mean scores demonstrated durability from 2 years to latest follow-up, and NAHS (P = .009), HOS-SSS (P = .02), and VAS (P = .04) continued to significantly improve. Fifty-one (54.3%) of cases reached patient acceptable symptomatic state for mHHS, and 49 cases (52.1%) achieved minimal clinically important difference for this outcome measure. Four cases (4.3%) required secondary arthroscopy, and survivorship was 72.3%. Compared with survivors, the subgroup requiring THA demonstrated higher body mass indexes (P = .01), had larger alpha angles (P = .0200) and smaller lateral center-edge angles (P = .0200), and had higher proportions of Tonnis grade 1 (P = .0012), acetabular Outerbridge grade >/= 2 (P = .0500), and femoral head Outerbridge grade >/=2 (P = .0001). CONCLUSIONS: Hip arthroscopy for the treatment of labral tears and FAI in patients >/=50 years old demonstrates statistically significant PRO improvements at minimum 5-year follow-up. However, due to potential for subsequent need for THA in a subset of this population, surgeons should use rigorous selection criteria and counsel patients appropriately. LEVEL OF EVIDENCE: Level IV, case series. CI - Copyright (c) 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. FAU - Perets, Itay AU - Perets I AD - American Hip Institute, Chicago, Illinois, U.S.A.; Hadassah Hebrew University Hospital, Jerusalem, Israel. FAU - Chaharbakhshi, Edwin O AU - Chaharbakhshi EO AD - American Hip Institute, Chicago, Illinois, U.S.A. FAU - Mu, Brian AU - Mu B AD - American Hip Institute, Chicago, Illinois, U.S.A. FAU - Ashberg, Lyall AU - Ashberg L AD - American Hip Institute, Chicago, Illinois, U.S.A. FAU - Battaglia, Muriel R AU - Battaglia MR AD - American Hip Institute, Chicago, Illinois, U.S.A. FAU - Yuen, Leslie C AU - Yuen LC AD - American Hip Institute, Chicago, Illinois, U.S.A. FAU - Domb, Benjamin G AU - Domb BG AD - American Hip Institute, Chicago, Illinois, U.S.A.. Electronic address: DrDomb@americanhipinstitute.org. LA - eng PT - Journal Article DEP - 20181006 PL - United States TA - Arthroscopy JT - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JID - 8506498 SB - IM CIN - Arthroscopy. 2018 Nov;34(11):3010-3011. PMID: 30392685 MH - Acetabulum/diagnostic imaging/injuries/*surgery MH - Aged MH - Arthroplasty, Replacement, Hip/*methods MH - Arthroscopy/*methods MH - Female MH - Femoracetabular Impingement/diagnosis/etiology/*surgery MH - Follow-Up Studies MH - Hip Fractures/complications/diagnosis/*surgery MH - Hip Joint/diagnostic imaging/*surgery MH - Humans MH - Male MH - Middle Aged MH - Patient Reported Outcome Measures MH - Patient Satisfaction MH - Radiography MH - Risk Factors MH - Time Factors MH - Treatment Outcome EDAT- 2018/10/12 06:00 MHDA- 2019/10/08 06:00 CRDT- 2018/10/11 06:00 PHST- 2017/10/27 00:00 [received] PHST- 2018/05/14 00:00 [revised] PHST- 2018/05/15 00:00 [accepted] PHST- 2018/10/12 06:00 [pubmed] PHST- 2019/10/08 06:00 [medline] PHST- 2018/10/11 06:00 [entrez] AID - S0749-8063(18)30455-9 [pii] AID - 10.1016/j.arthro.2018.05.034 [doi] PST - ppublish SO - Arthroscopy. 2018 Nov;34(11):3001-3009. doi: 10.1016/j.arthro.2018.05.034. Epub 2018 Oct 6.