Our Summary

This research paper reviews the existing literature on patient-reported outcomes and survival rates for those who have undergone a second hip arthroscopy procedure, where the labrum (the ring of cartilage that follows the outside rim of your hip joint socket) was either reconstructed or augmented. The authors looked at studies that reported patient outcomes both before and at least two years after the surgery, and they considered patients’ survival rate as them not having to undergo a total hip replacement.

They reviewed five studies involving 359 hip arthroscopy revisions. Of these, four were on the results of labral reconstruction, and one on labral augmentation. Patient outcomes seemed to improve after these surgeries, but the extent of improvement varied. The rate of patients achieving a notable clinical benefit was reported in three studies, with at least 70% of patients seeing a significant benefit in at least one aspect of their health or life. The survival rates after at least two years ranged from 93.5% to 100% - meaning that most patients did not require a total hip replacement within this time frame.

FAQs

  1. What did the research paper review about second hip arthroscopy procedures?
  2. What were the reported survival rates for patients two years after the surgery?
  3. What improvements were reported in patient outcomes after labral reconstruction or augmentation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about arthroscopy is to follow post-operative rehabilitation and physical therapy guidelines closely to ensure the best possible outcome and to reduce the risk of needing further procedures in the future. It is important to be patient with the recovery process and to communicate any concerns or changes in symptoms to your healthcare provider.

Suitable For

Patients who are typically recommended arthroscopy are those who have hip labral tears, hip impingement, cartilage damage, loose bodies in the joint, or other hip joint abnormalities that can be treated through minimally invasive surgery. These patients may have symptoms such as hip pain, stiffness, clicking or locking of the hip joint, and limited range of motion.

Arthroscopy is often recommended for younger, active patients who want to preserve their hip joint and avoid or delay more invasive procedures such as total hip replacement. It is also recommended for patients who have not responded to conservative treatments such as physical therapy, medication, and injections.

Overall, arthroscopy can be a beneficial treatment option for patients with hip joint issues, as it can improve pain, function, and quality of life, and potentially delay the need for more extensive surgery. However, it is important for patients to discuss their individual case with their healthcare provider to determine if arthroscopy is the right treatment option for them.

Timeline

Before arthroscopy:

  1. Patient experiences hip pain, limited range of motion, and possibly swelling in the hip joint.
  2. Patient consults with a doctor or orthopedic surgeon, who recommends arthroscopy as a minimally invasive surgical option.
  3. Patient undergoes pre-operative tests and evaluations to ensure they are a suitable candidate for arthroscopy.
  4. Patient schedules and undergoes the arthroscopic procedure, which typically lasts 1-2 hours and is performed under anesthesia.
  5. Patient may experience some pain and discomfort immediately following the surgery, but this is typically managed with medication and physical therapy.

After arthroscopy:

  1. Patient undergoes a period of post-operative recovery, which may involve physical therapy and rehabilitation to strengthen the hip joint.
  2. Patient gradually resumes normal activities and gradually increases their level of physical activity as advised by their healthcare provider.
  3. Patient experiences improvements in hip pain, range of motion, and overall function over time.
  4. Patient follows up with their surgeon for post-operative visits to monitor progress and address any concerns.
  5. In the long term, patient may experience sustained improvements in hip function and quality of life, with the majority of patients avoiding the need for a total hip replacement within at least two years post-surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with arthroscopy?
  2. What is the expected recovery time and rehabilitation process after arthroscopy?
  3. How long will the effects of the surgery last, and will I need further treatment in the future?
  4. What alternative treatment options are available for my condition, and how do they compare to arthroscopy?
  5. What is the success rate of arthroscopy for my specific condition, and what are the chances of needing a second procedure?
  6. How experienced are you in performing arthroscopic surgeries, and what is your success rate with this procedure?
  7. Will I need physical therapy after the surgery, and if so, for how long?
  8. Are there any lifestyle changes or modifications I should make post-surgery to improve my recovery?
  9. Will I need pain medication after the surgery, and how long will I need to take it for?
  10. Are there any restrictions on activities or movements I should be aware of after the surgery?

Reference

Authors: Lee MS, Fong S, Lee AY, Norman M, Mahatme RJ, Pettinelli N, Park N, Gagné J, Gillinov SM, Islam W, Jimenez AE. Journal: Arthroscopy. 2024 Jun;40(6):1923-1937. doi: 10.1016/j.arthro.2023.11.027. Epub 2023 Dec 27. PMID: 38154532