Only 5% of hips analysed in published hip arthroscopy literature were reported to have an accurate osseous impingement correction on adequate postoperative radiographs: a systematic review of nearly 30 000 hips.

Abstract

To perform a systematic review that identifies the percentage of arthroscopic hip surgery publications that obtain postoperative plain radiographs (and type, and when) and the accuracy of the osseous corrections performed. A systematic review was conducted utilizing PRISMA guidelines. Arthroscopic hip preservation surgery publications were included over a 20-year publication eligibility period. Synthetic reviews were excluded. Studies reporting accuracy of correction based on intra-operative fluoroscopic and/or dynamic arthroscopic examination alone, but without postoperative plain radiographs, were excluded. Publications were screened for the presence, type, and timing of postoperative radiographs and measurements performed quantifying femoral head-neck junction sphericity. Descriptive statistics and logistic and multivariate regression analyses were performed. Two-hundred fifty-six publications (29 381 hips; 14 692 female; mean age range 14.8-65.8 years). The most common surgical indication was labral tear (13 112 hips [44.7% of hips]). There was an inverse correlation between publication year and obtaining postoperative radiographs (<i>r</i> = -0.128, <i>P</i> < .05). Only 69 publications (27%) reported obtaining postoperative radiographs. Among those, 40 publications (16%) specified the type of radiographs. Only 22 publications (9%; 1538 hips [5% of hips]) reported that patients had an accurate osseous correction. This systematic review has shown that only 9% of arthroscopic hip preservation surgery publications (5% of hips) reported an accurate osseous correction on postoperative radiographs. Given this finding, writers, reviewers, editors, and publishers of hip preservation surgery literature should necessitate the transparent reporting of the accuracy of osseous corrections performed on standardized radiographs. Level IV, systematic review and/or meta-analysis of studies with Levels I to IV.