KSSTA - 2026-09-17 - Journal Article
Comparable functional outcomes after total hip arthroplasty in patients with and without prior ipsilateral hip arthroscopy: A comparative cohort study.
Krautter J, Feil S, Thorey F
Topics
Key Takeaway
Prior ipsilateral hip arthroscopy does not compromise post-THA functional outcomes, with comparable HOOS subscales at mean 52.6 months except QoL (HA-THA 75.7 vs THA 82.9, p=0.009).
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Summary
This retrospective cohort study compared functional outcomes after THA in patients with prior ipsilateral hip arthroscopy (conversion >6 months) versus primary THA. Both groups achieved significant improvement across all HOOS subscales, with the primary THA group showing greater mean improvement (p<0.001), but postoperative scores were equivalent except for the QoL subscale (HA-THA 75.7 vs THA 82.9, p=0.009). Revision rate in the HA-THA group was 3.4% (3/89), and higher BMI independently predicted worse outcomes in the primary THA cohort.
Key Limitation
The retrospective design precludes standardization of arthroscopic procedures performed before THA, meaning heterogeneity in prior labral repair, capsulotomy technique, and cartilage status is uncontrolled and likely confounds the QoL subscale difference.
Original Abstract
PURPOSE
To evaluate whether prior ipsilateral hip arthroscopy (HA) influences the functional outcome of subsequent total hip arthroplasty (THA) in patients with a conversion time of more than 6 months, compared with primary THA.
METHODS
In this retrospective cohort study, patients were categorised into two groups, those with prior HA to THA (HA-THA) and those with primary THA (THA). The primary outcome measure was the Hip Disability and Osteoarthritis Outcome Score (HOOS). Secondary outcomes comprised complication rate, revision rates and patient-reported outcome measures (PROMs) including Harris Hip Score (HHS), Oxford Hip Score (OHS) and Visual Analogue Scale.
RESULTS
A total of 546 patients (HA-THA: n = 89;
THA
n = 457) with a mean age of 67.0 ± 13.3 years (54% male) and mean follow-up of 52.6 ± 28.1 months were included. Both groups demonstrated a significant improvement from pre- to post-operatively in all HOOS subscales with a significantly higher mean improvement in THA (p < 0.001). Postoperatively, HOOS subscales showed no significant differences between groups except quality of life (HA-THA: 75.7 ± 24.0;
THA
82.9 ± 18.2; p = 0.009). Three patients in HA-THA (3.4%) required a revision surgery. Higher BMI was associated with worse functional outcome in THA group.
CONCLUSION
Prior ipsilateral HA was not associated with inferior PROMs after THA compared with primary THA. Patients undergoing THA after previous HA can therefore be counselled that a prior HA is unlikely to compromise the functional result of subsequent arthroplasty, but the timing of conversion may be relevant to complication and revision rates.
LEVEL OF EVIDENCE
Level III, retrospective comparative cohort study.