The results of hip arthroscopy clearly depend on the condition being treated. Some patients do well, some not so well. A major problem, of course, is that sometimes one simply does not know what the condition is until hip arthroscopy has been performed. In addition, hip conditions rarely occur in isolation. It would be quite normal, for example, for a patient to present with a combination of femoroacetabular impingement, a loose body and some osteoarthritis. Consequently, to predict ahead of time how a patient will do after surgery can only ever be a professional estimate. However, in outline, the results may be summarised as follows:
- Diagnostic hip arthroscopy
There is an almost 100% chance that a diagnosis may be given to a patient after a diagnostic hip arthroscopy. However, although a surgeon may find something that looks abnormal within the hip joint it is sometimes difficult to say whether the abnormality is the cause of a patient’s pain.
- Femoroacetabular impingement (FAI)
Results for FAI surgery have improved in recent years. Now, approximately 80% of patients will show an improvement in their symptoms at the one-year review point after surgery, 15% will be the same and 5% will be worse.
- Osteoarthritis (OA)
OA is not a classic indication for hip arthroscopic surgery but it may still sometimes be recommended. If so, the chances of success are approximately 40% at one year, with 45% of patients being the same and 15% being worse.
- Ligamentum teres tears
These do surprisingly well, for reasons which are unclear. However, more than 90% of patients with tears of the ligamentum teres do well after debridement (surgical cleaning), or shrinkage of the partially torn ligamentum. The results for ligamentum teres reconstruction are still unavailable as this is such a new area for hip arthroscopic surgery.
- Infection
Fortunately, infections of the hip joint are rare. However, should they occur then hip arthroscopy is one good way of identifying the organism involved and thoroughly cleaning the hip joint. Because of the huge diversity of bacteria which can cause infections, some of which are quite virulent and some of which are not, it is difficult to give a precise figure for success rates.
- Synovitis
This term implies an inflammation of the lining of the hip joint (synovium). Hip arthroscopy is a good way of identifying a synovitis and removing (synovectomy) the inflamed area. However, the procedure cannot reverse any damage caused by the synovitis so results are difficult to predict as they will depend on how much damage has been caused before the hip arthroscopy is undertaken.
- Loose bodies
If loose bodies are identified early in their development then the success rate of surgery is good, well over 80% at one year. However, the longer a loose body stays in place, the higher the chance of damage occurring, so that it may eventually become difficult to undo the damage which has been caused. It is quite common for loose bodies to recur after surgery, so it is sometimes necessary for a surgeon to undertake a further hip arthroscopic procedure at a later date to remove the recurrent loose bodies.
- Painful joint replacement
Although the purpose of performing a hip arthroscopy of a painful joint replacement is to see what is causing a patient’s pain, it seems that about 40% of patients can be improved by arthroscopic surgery anyway. In about 90% of patients with a painful joint replacement, but for whom the reason for the pain is unclear, a reason can be given for their pain after hip arthroscopy. This is useful when planning future treatment.
- Trochanteric bursitis
Trochanteric bursitis describes a condition of pain over the outer (lateral) aspect of the hip joint, although it is now realised that pain in this area can be caused by many different problems. The area is easily accessible to the hip arthroscopist, although the results of surgery are not as good as they might be for certain other hip conditions. Approximately 70% of patients can be improved by hip arthroscopic surgery to these lateral hip structures.