Table 2.
Results of comparison of effects of hip arthroscopy OA versus no OA
| Study (first author, year) | Study characteristics | Sample characteristics | Effect size at followup | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total score using modified Downs and Black appraisal [maximum17 points] | Arthroscopic intervention for OA pathology | Classification of OA pathology | FAI (Y/N; type) | Sample size (OA subsample) | Sex | Age (years)* | Duration of symptoms (months) † | Follow up (months)† | Outcome | (95% CI) | Study conclusions (where effect size = ID) | Difference between groups reported | |
| Egerton (2013) [14] | 13 | Débridement, microfracture | Chondral damage Outerbridge ≥ 1 | N | 560 (108) | 277 F; 283 M | 42 | NR | 12 | mHHS NAHS |
mHHS no OA 0.82 (0.75–0.90) mHHS OA 0.62 (0.50–0.73) NAHS no OA 0.89 (0.81–0.97) NAHS OA 0.44 (0.35–0.52) |
mHHS p = 0.001 NAHS p < 0.001 |
|
| Gedouin (2010) [17] | 10 | Débridement, microfracture | Preoperative radiograph Tönnis Grade 0 or 1 | N | 110 (45) | 32 F; 78 M | 31 | 10 | 15 | WOMAC | WOMAC no OA 1.23 (0.93–1.53) WOMAC OA 0.95 (0.67–1.22) |
p < 0.001 | |
| Larson (2011) [32] | 13 | Débridement, microfracture | Group FAI–no joint space narrowing Tönnis 0 to 1 (n = 154) Group FAI OA–joint space narrowing Tönnis > 1 (n = 56) |
Y (cam, pincer, and mixed) | 227 (56) | Group FAI 81 F; 88 M Group FAI OA 13 F; 43 M |
Group FAI 32 Group FAI OA 45 |
NR | 27 | mHHS SF-12 VAS |
ID | Group FAI preoperative mHHS 63; postoperative mHHS 88; improved 25 points (p < 0.001) Group FAI OA preoperative mHHS 60; postoperative mHHS 67 points; improved 7 points (p = 0.986) Predictors of lower mHHS were joint space narrowing (p = 0.001); greater duration of symptoms (p = 0.014); higher grade chondropathy preoperative MRI (p = 0..019) |
P < 0.001 |
| Palmer (2012) [44] | 15 | Chondroplasty, microfracture | Outerbridge 0–3 (n = 157) Outerbridge 4 (n = 44) Chondral defects < 1.5 cm2 (n = 201) |
Y (cam, pincer, and mixed) | 201 (201) | 102 F; 99M | 40 | 59 | 46 | NAHS | ID | 13 of 201 patients progressed to THA Outerbridge 0–3 NAHS improved 23 points (p < 0.001) Outerbridge 4 NAHS improved 25 points (p < 0.001) Pincer FAI NAHS improved 16 points; no pincer FAI improved 23 points (p < 0.01) |
p = 0.48 |
| Stahelin (2008) [50] | 9 | Débridement, microfracture | Preoperative radiograph Tönnis 0 (n = 14); Tönnis 1 (n = 5); Tönnis 2 (n = 3) | All patients cam FAI | 22 (8) | 7 F; 15 M | 42 | 6 | NAHS VAS |
NAHS Tönnis 0 1.55 (0.74–2.36) NAHS Tönnis 1–2 0.92 (0.28–1.55) VAS Tönnis 0 2.26 (1.08–3.45) VAS Tönnis 1–2 1.63 (0.50–2.75) |
p < 0.05 | ||
* Mean (SD); †range; OA = osteoarthritis; FAI = femoroacetabular impingement; Y = yes; N = no; CI = confidence interval; mHHS = modified Harris hip score range 0–100 points, 100 points = best possible outcome; VAS = visual analog scale score range 0–10 points, 0 points = best possible outcome; HHS = Harris hip score range 0–100 points, 100 points = best possible outcome; NAHS = Non-arthritic Hip Score score range 0–100 points, 100 points = best possible outcome; WOMAC score range 0–100 points, 100 points = best possible outcome; HOS = Hip Outcome Score; ADL = activities of daily living; F = female; M = male; ID = insufficient data; Tönnis = preoperative grading of osteoarthritis using Tönnis scale; Outerbridge = intraoperative grading of chondral injury; NR = not reported; NS = not specific.