37. HIP ARTHROSCOPY MAY CAUSE CHONDROLYSIS

Abstract

Purpose: Hip arthroscopy has been used at an increasing frequency over the last few years. Majority of patients undergoing hip arthroscopy are young and active individuals who seek definitive therapy for a painful hip condition and wish to avoid undergoing a hip replacement. Although relatively successful, complications following hip arthroscopy occur. This multi-institutional study presents a worrisome and previously unrecognized complication of hip arthroscopy, namely chondrolysis that lead to accelerated development of end-stage arthritis.

Method: Using the computerized database in each institution, patients undergoing total hip arthroplasty between 1999–2008 who had received hip arthroscopy prior to arthroplasty were identified. 39 patients were identified to have undergone at least one hip arthroscopy on the affected hip prior to arthroplasty. There were 21 female and 18 male patients. The mean age of patients at the time of hip arthroscopy was 45.9 years. Data regarding demographics, comorbidities, preoperative diagnosis, number of previous procedures, and the details of the surgical procedure were compiled. Radiographs were evaluated.

Results: The median time from arthroscopy to arthroplasty was 14.8 months (range 2.2 months to 7 years). Fourteen patients (35%) underwent THA within 12 months of a previous hip arthroscopy and in nine of these patients the indication for hip arthroscopy was labral tear debridement. These patients despite having none to minimal arthritis at the time of arthroscopy developed accelerated arthritis within a year that necessitated hip replacement.

Conclusion: Hip arthroscopy can cause accelerated degenerative arthritis of the hip in some patients. We believe the subset of our patients who developed arthritis so early after hip arthroscopy may have suffered chondrolysis and/or chondral injury during the arthroscopy that resulted in progressive and aggressive arthritis of the hip within 12 months. Hip arthroscopy should be reserved for a select group of patients. All measures to minimize the possibility of chondrolysis and/or chondral injury should be exercised.