Clinician-scientists at the Steadman Philippon Research Institute set out to examine outcomes following revision hip arthroscopy in adolescents. Their study was published in the December 2016 edition of The American Journal of Sports Medicine. Marc Philippon, M.D., a partner at The Steadman Clinic, gave OTW background on the study, saying, “There was a noticeable increase in the number of hip injuries in young athletes in my practice, particularly in hockey and ballet. Many of these athletes had a previous hip surgery somewhere else. The goal was to get these young athletes back to where they were before their injuries, so to see if this was possible, we tracked their outcomes.”
Outcome Scores Lower for Adolescent REVISION Hip Surgery
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Secondary
Forty-two patients were included in the revision group; they were matched with 84 patients in the primary group. The main outcome measure was the Hip Outcome Score for Activities of Daily Living Scale (HOS-ADL); the HOS for Sports Scale (HOS-Sport), modified Harris Hip Score (mHHS), and 12-Item Short Form Health Survey Physical Component Summary (SF-12 PCS) were also used.
The authors wrote, “At follow-up, there were no significant differences between the primary and revision groups for the HOS-ADL values and SF-12 PCS values. Patients in the primary group had significantly higher HOS-Sport values, mHHS values, and patient satisfaction. Patients who underwent one prior hip arthroscopic procedure had a higher mean postoperative mHHS value (79.5 versus 72, respectively), HOS-ADL value (91.2 vs 73.4, respectively), and HOS-Sport value (76 vs 60, respectively) compared with those who underwent more than one prior procedure.”
Dr. Philippon commented to OTW, “The young athletes that had revision surgery had significant improvement in symptoms and function and they were able to return to athletics. They had similar improvement to those young athletes who had not had a previous surgery.”
“If patients had more than one previous surgery, they had decreased outcome scores compared to those who just had one previous surgery and those who had no previous surgeries. This highlights the need for more research on avoiding revision surgery.”
“This article highlights the importance of injury prevention and adequate treatment of hip injuries in young athletes to ensure they can remain active for a lifetime. It is part of the mission of the Steadman Philippon Research Institute to keep people active through our research.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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