Hip arthroscopy versus total hip arthroplasty in patients above 40 differences: outcome and residual complain
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ORIGINAL ARTICLE
Hip arthroscopy versus total hip arthroplasty in patients above 40 differences: outcome and residual complain Richard Niehaus1 · Patrick O. Zingg1 · Martin Luttenberger1 · Claudio Dora2 Received: 2 February 2020 / Accepted: 22 April 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract This study aimed to compare patient outcomes and residual complains after hip arthroscopy (HAS) and total hip arthroplasty (THA) to improve patient counseling. It includes 140 hips/129 HAS-patients and 77 hips/62 THA-patients aged 40 to 55 years with a BMI under 30. All patients underwent primary HAS or primary THA in our hospital from 2007 until 2014. Exclusion criteria were a history of prior hip surgery or suffering sequels of childhood’s hip disease, systemic inflammatory disease or avascular hip osteonecrosis. Outcome measures were WOMAC, subjective hip value, residual complains, the need of infiltrations and the complication and conversion rate. Patient data and scores were collected pre-operative, after one year and at the last follow-up. Scores indicated significant patient benefits in both groups (p 30, a history of hip surgery, or sequels of childhood’s hip disease, Fig. 1 Reproducible description of the patient selection process with and 140 hips for the HAS group and 77 hips qualifying for the THA group
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European Journal of Orthopaedic Surgery & Traumatology
systemic inflammatory disease, or avascular osteonecrosis of the hip were excluded. This led to a HAS group of 129 patients with 140 hip arthroscopies (Fig. 1).
THA group Between January 2007 and December 2013, a total of 2923 primary total hip arthroplasties were performed by six experienced surgeons. Patients aged 55 years with a BMI > 30, a history of hip surgery or sequels of childhood’s hip disease, systemic inflammatory disease or avascular osteonecrosis of the hip were excluded. This resulted in a THA group of 62 patients with a total of 77 hip arthroplasties (Fig. 1).
Evaluation The patient’s demographic data, indications to surgery, complications and re-interventions were extracted from medical reports. A WOMAC (Western Ontario und McMaster Universities Arthritis Index) [10] and the SHV (subjective hip value) were used prospectively to document the subjective hip status of all patients before surgery, 12 months after surgery and at the last follow-up. The SHV is defined as a patient’s subjective hip assessment, expressed as a percentage of a completely normal
European Journal of Orthopaedic Surgery & Traumatology
hip that would reach 100% (analogous to the “subjective shoulder value” by Gerber and Gilbert [11]). Finally, residual complaints, the use of therapeutic joint infiltrations, reoperations and complications were recorded.
Statistical methods A two-tailed Kolmogorov–Smirnov test was used to analyze data distribution. Nonparametric continuous data are presented by median and range and analyzed by using the Mann–Whitney U-test. The parametric data are presented by mean ± standard deviation and analyzed
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