Hip Arthroscopy: Labral Repair in Patients Older than … · • The mean age was 58 years (range,...
Transcript of Hip Arthroscopy: Labral Repair in Patients Older than … · • The mean age was 58 years (range,...
Tomer Ben Tov1, Eyal Amar1, Oren Tsvieli2, Guy Morag3, Moshe Salai1, 3, Ehud Rath1
1. Minimal Invasive Surgery Unit, Division of Orthopedic Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
2. Orthopedic department, Soroka University Medical Center, Beer Sheva, Israel
3. Sport Medicine Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
HIP ARTHROSCOPY: LABRAL REPAIR IN PATIENTS OLDER
THAN 50 YEARS OLD
HIP ARTHROSCOPY: LABRAL REPAIR IN PATIENTS OLDER
THAN 50 YEARS OLD
• None of the authors have a conflict of interest.
• None of the following exist:
• Royalties and stock options.
• Consulting income.
• Research and education support.
• Other support.
INTRODUCTION: • Femoroacetabular impingement is a recognized etiology of intra-
articular pathology and subsequent osteoarthritis in adults.
• Arthroscopy has been useful in the management of hip pathologies and has been proposed as a method of correcting the underlying impingement as a cause of late OA.
• The purpose of this study is to report the results of our early experience in the arthroscopic management of femoroacetabular impingement and arthroscopic labral repair in patients older than 50 years old.
METHODS: • Cohort of 22 patients older than 50 years. • January 2010 to January 2012. • Single surgeon. • All patients prospectively assessed with a Modified Harris Hip
Score. • 20/22 patients had Hip Outcome Score.
METHODS: • The mean age was 58 years (range, 50 to 75 years).
• 16 female and 6 male patients.
Patient # Age Sex Side Preop. MHHS Preop. Function Preop. HOS Postop. MHHS Postop. Function Postop. HOS
1 52 F L 30.8 no data 33 10% improvement no data
2 51 F R 60.4 10% 32.8 95.6 60% 89.1
3 55 F L 59.3 10% 39 92.3 80% 64.3
4 67 F R 36.3 30% 16.1 95.6 100% 100
5 54 F L 86.8 50% 64.7 100 90% 95
6 60 M R 87.9 65% 85.9 100 85% 100
7 62 F L 71.4 50% 44.6 92.3 80% 82.1
8 57 M R 68.1 55% 84.4 94.5 60% 95.3
9 63 M L 75.8 30% 72 91.2 75% 83.3 10 52 M L 53.8 40% 46.7 74.7 65% 71.9 11 61 M L 53.8 50% no data 53.8 50% no data
12 51 F L 67 50% 61.7 95.6 90% 91.7
13 50 F R 41.8 40% 23 57.1 60% 79
14 53 F L 87.9 60% 90.3 87.9 60% 90.3
15 56 F L 31.9 20% 35.5 55.6 50% 56.6
16 63 M R 58.2 50% 44.1 91.2 70% 85.5
17 60 F R 56 40% 69.7 56 40% 69.7
18 75 F L 45.1 50% 56.0 79.1 80% 89.7
19 64 F L 54.9 50% 26.4 95.6 70% 90.6
20 66 F R 58.2 60% 64.5 95.6 80% 90.6
21 52 F R 68.1 70% 72.1 95.6 90% 90.6
22 52 F R 59.3 60% 59.2 100 90% 86.8
Labral tear in 60 y.o female
Labral tear in 54 y.o female
Acetabuloplasty + labral repair
RESULTS: • All the patients report improvement of pain and function after the
surgery. • Mean Modified Harris Hip Score improvement was 23.6 points
(from 59.7 preop. to 83.3 postop.). • Mean Hip Outcome Score improvement was 30.7 points (from
54.4 preop. to 85.1 postop.). • A mean of 27% increase in the level of function during usual
activities of daily living.
MODIFIED HARRIS HIP SCORE:
0
20
40
60
80
100
PRE-OP POST-OP
MHHS
HIP OUTCOME SCORE:
0
20
40
60
80
100
PRE-OP POST-OP
HOS
CONCLUSIONS: • Arthroscopic management of femoroacetabular Impingement
and labral repair in patients older than 50 years is associated with significant improvement in outcome at most recent follow-up.
• Because of the potential important rule of the labrum for long term hip joint integrity we advocate preservation of the labrum when surgically managing FAI in patients older than 50.
THANK YOU