Hip arthroscopy for intra-articular pathology: a systematic review of outcomes with and without femoral osteoplasty
- Joanne L Kemp1,2,
- Natalie J Collins1,2,
- Michael Makdissi1,3,
- Anthony G Schache2,
- Zuzana Machotka4,
- Kay Crossley1,2,5
- 1Melbourne School of Physiotherapy, The University of Melbourne, Melbourne, Australia
- 2Melbourne School of Engineering, The University of Melbourne, Melbourne, Australia
- 3Melbourne Brain Centre, Florey Neurosciences Institute, University of Melbourne, Australia
- 4International Centre for Allied Health Evidence (iCAHE), University of South Australia, Adelaide, Australia
- 5School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Correspondence to Kay Crossley, Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia 4072;
- Received 21 July 2011
- Accepted 3 November 2011
- Published Online First 22 December 2011
Background Arthroscopy is increasingly used to improve pain and function in athletes with hip joint pathology. Surgical techniques have evolved to utilise arthroscopic femoral osteoplasty to address potential morphological contributors to pathology.
Purpose Investigate pain and function outcomes following hip arthroscopy with and without femoral osteoplasty in individuals with intra-articular hip pathology.
Study design Systematic review.
Methods A comprehensive search strategy identified studies that evaluated the outcome over at least 3 months following arthroscopy for intra-articular hip pathology, using patient-reported outcomes of pain and/or function. Methodological quality was evaluated (Downs and Black scale), and effect sizes calculated when sufficient data were available.
Results Twenty-nine studies of moderate methodological quality were included. Of 16 studies investigating arthroscopy alone, two studies showed large effects (3.12–5.46) at 1–2 years. Pain reduction and functional improvement (median 47%) were consistently reported by the remaining 14 studies up to 10 years postsurgery. Of 15 studies investigating arthroscopy with osteoplasty, nine papers showed mostly large effects (0.78–2.93) over 6–28 months. Adverse events were minimal (7% of participants, 12 studies, predominantly transient neuropraxia (83%)).
Conclusion Current evidence indicates that hip arthroscopy can significantly reduce pain and improve function in patients with intra-articular hip pathology. While benefits of arthroscopy alone can persist up to 10 years postsurgery, effects of osteoplasty beyond 3 years need to be established. Future studies should investigate rehabilitation in this population, and the impact of surgery on development of osteoarthritis.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.