Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlesThe relationship between diagnosis and outcome in arthroscopy of the hip☆
Section snippets
Methods
From January 1995 to February 1998, 84 patients with refractory hip pain in 86 hips were treated at our institution with arthroscopy of the hip performed by a single surgeon (T.P.V.). The majority (37 hips) of these cases were performed for a diagnosis of ON either before or following free-vascularized fibular grafting. The remainder of the cases (49 hips) are discussed in detail to provide a cohort of patients and diagnoses with which to compare the outcome of diagnostic and therapeutic
Results
The average age of the patients was 33.6 years, with a range of 11 to 65 years. There were 53 male (63%), and 31 female (37%) patients. In only 2 cases was clicking or popping elicited during physical examination (Table 1).The clinical indications for this procedure included ON (without FVFG), 5 patients (5.8%); ON (after FVFG), 32 patients (37.2%); labral injuries, 22 patients (25.6%); degenerative arthritis, 9 patients (10.5%); the late sequelae of LCP disease, 9 patients (10.5%); and loose
Discussion
The purpose of this study was to compare the results of arthroscopy in the treatment of ON in patients without prior surgical intervention and in those with unsatisfactory results following FVFG with the results obtained in the treatment of other diagnoses. Additionally, we sought to further define the clinical indications for hip arthroscopy, document the resultant outcome of the procedure, identify any significant prognostic factors, and report any associated complications. This study
Conclusions
The authors’ experience with arthroscopy of the hip demonstrates the application of the procedure in a diverse patient population with a variety of clinical indications and the subsequent outcome of each group. Further, this patient population identifies patients with ON following FVFG and unequivocal mechanical symptoms as potential beneficiaries of arthroscopic treatment. Regardless of preoperative diagnosis, the presence of definite mechanical symptoms was an important prognostic indicator
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Address correspondence and reprint requests to Thomas Parker Vail, M.D., Department of Surgery, Division of Orthopaedic Surgery, Duke University Medical Center, DUMC Box 3332, Durham, NC 27710, U.S.A.