13.
Hip Arthroscopy with labral repair, a prospective evaluation of the
clinical outcome within the first year after surgery
Christian Dippmann, Kristian Thorborg, Kraemer Otto, Henrik Palm, Søren
Winge, Hölmich Per
Arthroscopic Center Amager Copenhagen University Hospital, Hvidovre,
Denmark; Arthroscopic Center Amager, Copenhagen University Hospital,
Hvidovre, Denmark; Arthroscopic Center Amager, Copenhagen University
Hospital, Hvidovre, Denmark; Department of Orthopedic Surgery,
Copenhagen University Hospital, Hvidovre, Denmark; , Copenhagen Private
Hospital; Arthroscopic Center Amager, Copenhagen University Hospital,
Hvidovre, Denmark
Background:
The clinical outcome after hip arthroscopy for femoro-
acetabular impingement (FAI) has been shown to improve substantially after 1
to 2 year. When this observed clinical improvement occurs during the first year
has, however, not been evaluated
Purpose / Aim of Study:
The purpose of this study was to examine the
development of clinical outcome after hip arthroscopy with labral repair during
the first postoperative year.
Materials and Methods:
From May 2009 to December 2010, 58 consecutive
patients, 37F (mean age 37 (16-59)) and 21M (mean age 43 (range 22-61)),
underwent a hip arthroscopy and labral repair, by the same experienced
surgeon (OK). Standardised, but unstructured, post- op. mobilisation
instructions were provided. Preop. 3, 6 and 12 months post-op., the patients
were assessed with the modified Harris Hip Score (mHHS) and pain VAS
score. Data was prospectively collected and analysed using non-parametric
statistics.
Findings / Results:
Patient-reported improvements were seen for both
outcome measures over time, p< 0.001. The primary outcome, mHHS (Median
(25-75
percentiles)) improved from preoperatively to three months (60 (48-67)
to 71 (64-92), p<0.001), and continued to improve from 3 to 6 months
71(63.5-92)
to 83.5 (64.5-99), p<0.01, with no further improvement. The pain
VAS score also improved from preoperatively to 3 months (61(47-73) to 24(9-
44),
p<0.001), and from 3 to 6 months from 24(9-44) to (14(5-37), p<0.05),
with no further improvement.
Conclusions:
Large clinically relevant improvements in function and pain
were seen in patients with FAI after hip arthroscopy, including labral repair, at
3
and 6 months. Interestingly, no further clinical improvement seems to occur
after 6 months. A more structured post-op. exercise program may however,
further improve the clinical outcome on a longer term.
