Adolescents Who Underwent Revision Hip Arthroscopy Showed Comparable Magnitude of Improvement but Had Lower Clinical Benefit Rates and Higher Risk of Subsequent Surgeries Compared to a Propensity-Matched Primary Group at 2-Year Follow-Up.

Abstract

To compare minimum 2-year patient-reported outcomes measures (PROMs) between adolescents undergoing primary and revision hip arthroscopy. Data were prospectively collected and retrospectively reviewed for adolescents who underwent revision hip arthroscopy from November 2008 and November 2021. Patients with baseline and minimum 2-year PROMs were included. Exclusion criteria were patients over 19 years old or dysplastic. A propensity-matched comparison was performed to a primary control group in a 1:2 ratio based on age at surgery, sex, body mass index, and acetabular Outerbridge grade. PROMs, clinical benefit achievement rates, and secondary surgeries were reported and compared. Thirty-five adolescents (37 revisions hips) were included and propensity-matched. Significant improvement was noted for modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score Sport-Specific Subscale, International Hip Outcome Tool, patient satisfaction, and visual analog scale for pain in both groups (P < .01). The revision group had significantly lower postoperative values for all the PROMs (P < .01); however, improvement (delta value) was similar. Revision hips underwent secondary arthroscopy at higher rates when compared with primary hips (21.6% vs 5.4%; P < .05) and were 4.83 times as likely to receive an additional rerevision surgery. Adolescents undergoing revision arthroscopy showed significant improvement in all PROMs (modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score Sport-Specific Subscale, International Hip Outcome Tool, and visual analog scale for pain) at a minimum 2-year follow-up. When compared with a propensity-matched primary control group, revision hips had lower preoperative and postoperative values, but similar improvement magnitude for all PROMs, but met clinically meaningful thresholds at lower rates, and were 4.83 times more likely to require a subsequent hip arthroscopy. Level III, retrospective comparative study.