Our Summary

This research used data from the US Medicare system to study how often hip arthroscopy (a minimally invasive surgical procedure on the hip joint) is used in elderly patients and what factors may lead to these patients later needing a full hip replacement (total hip arthroplasty, or THA). The study looked at data from 2005-2014 and found that the use of hip arthroscopy in this population has dramatically increased by 280%. The most common reason for the surgery was for chondroplasty and/or resection of labrum (treatments for damaged cartilage in the joint).

About 18.5% of the patients who had hip arthroscopy ended up needing a full hip replacement within two years. Patients aged 65-74 and those already diagnosed with osteoarthritis (a type of joint disease) were more likely to need a hip replacement. The study also found that having the surgery repeated did not make a patient more likely to need a hip replacement.

The researchers concluded that, while hip arthroscopy is being used more often in older patients, it should be used with caution, particularly in patients already diagnosed with osteoarthritis and those aged 65-74, due to the increased risk of needing a full hip replacement.

FAQs

  1. How much has the use of hip arthroscopy in elderly patients increased according to the data from the US Medicare system?
  2. What factors were found to increase the likelihood of a patient needing a full hip replacement after hip arthroscopy?
  3. What is the recommendation of the researchers regarding the use of hip arthroscopy in older patients?

Doctor’s Tip

A doctor might tell a patient considering arthroscopy to be aware of the potential risks and outcomes, especially in older patients with existing joint conditions like osteoarthritis. It’s important to have a thorough discussion with your doctor about the benefits and potential need for future surgeries, such as hip replacement, before proceeding with arthroscopy.

Suitable For

Overall, patients who are typically recommended arthroscopy are those who have joint issues such as damaged cartilage, torn ligaments, or inflammation in the joint that can be addressed through minimally invasive surgery. However, based on the findings of this study, older patients with pre-existing conditions such as osteoarthritis may be at a higher risk of needing a full joint replacement after arthroscopy. It is important for healthcare providers to carefully consider each patient’s individual risk factors and potential benefits of arthroscopy before recommending the procedure.

Timeline

Before arthroscopy:

  • Patient experiences hip pain and limited range of motion in the hip joint
  • Patient may undergo imaging tests such as X-rays or MRI to diagnose the issue
  • Patient may try conservative treatments such as physical therapy or medication to manage symptoms

After arthroscopy:

  • Patient undergoes minimally invasive surgery to address the issue in the hip joint
  • Recovery period includes physical therapy and rehabilitation to regain strength and mobility
  • Patient may experience reduced pain and improved function in the hip joint
  • Follow-up appointments with the surgeon to monitor progress and address any complications

If needed, patient may later require a total hip arthroplasty (hip replacement surgery) due to continued joint damage or osteoarthritis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hip arthroscopy in elderly patients?
  2. How long is the recovery process after hip arthroscopy in elderly patients?
  3. Are there alternative treatment options for my hip condition aside from hip arthroscopy?
  4. Will hip arthroscopy improve my symptoms and quality of life in the long term, or is a hip replacement a more effective option?
  5. What criteria should be met for me to be a good candidate for hip arthroscopy at my age?
  6. How often do elderly patients who undergo hip arthroscopy end up needing a hip replacement in the future?
  7. What measures can I take to potentially reduce the risk of needing a hip replacement after hip arthroscopy?
  8. Are there any specific exercises or physical therapy programs that can help optimize the outcomes of hip arthroscopy in elderly patients?
  9. How experienced is the surgeon in performing hip arthroscopy on elderly patients, and what is their success rate with this procedure?
  10. What is the expected timeline for follow-up appointments and monitoring after hip arthroscopy in elderly patients?

Reference

Authors: Malik AT, Jain N, Scharschmidt TJ, Glassman AH, Khan SN. Journal: Hip Int. 2022 Mar;32(2):239-245. doi: 10.1177/1120700020951171. Epub 2020 Aug 31. PMID: 32866054