Prior Arthroscopy Leads to Inferior Outcomes in Total Hip Replacement: A Match-Controlled Study

Background: Total hip arthroplasty (THA) is one of the most common reoperations after hip arthroscopy. Although arthroscopy causes changes in the hip joint and the surrounding soft tissues that can make THA more challenging, previous reports on arthroscopy prior to THA have not demonstrated any significant effect on clinical outcomes.

Methods: Patients that underwent a THA following an ipsilateral hip arthroscopy were matched to a control group of THA patients with no history of ipsilateral hip surgery. Matching criteria were age within five years, sex, BMI within five, surgical approach, and robotic assistance. Harris Hip Score (HHS), Forgotten Joint Score 12 (FJS-12), visual analog score (VAS), satisfaction, and postoperative complication and reoperation rates were compared at minimum two-year follow-up.

Results: Thirty-five prior arthroscopy patients were successfully matched to control patients. There were no significant differences in demographics between study groups. The prior arthroscopy group had significantly lower HHS, FJS-12, and satisfaction at latest follow-up. They had higher VAS and complication rate in differences that closely approached significance. There was no significant difference in reoperation rate.

Conclusion: A prior hip arthroscopy may adversely affect the clinical outcomes of THA. This potential risk should be considered when assessing the candidacy of a patient for hip arthroscopy.