Table 3.
Summary of included studies evaluating risk of progression to THA in people with hip OA undergoing hip arthroscopy
| Study (first author, year) | Total score using modified Downs and Black appraisal (maximum 17 points) | Intervention for OA pathology | Classification of OA pathology | Sample size | Sex | Age (years)* | Duration symptom | Followup time to THA (mean) | Study conclusions regarding THA risk |
|---|---|---|---|---|---|---|---|---|---|
| Gedouin (2010) [18] | 10 | Débridement, microfracture | Preoperative radiograph Tönnis Grade 0 or 1 | 110 (45) | 32 F; 78 M | 31 | 10 months | 1 year | 5 of 110 patients progressed to THA |
| Haviv (2010) [19] | 10 | Débridement; microfracture | All patients–Outerbridge 4 Mild = < 30% acetabulum Moderate = > 30% acetabulum Severe = also femoral head |
90 | 55 F; 35 M | 55 | NR | Mild–2.2 years Moderate–1.2 years Severe–1.1 years Overall–1.5 years |
Pearson’s correlation Age versus time to THA r = −0.34 Severity cartilage change versus time to THA r = −0.35 If age < 55 years, time to THA 1.9 years If age > 55 years, time to THA 1.2 years (p = 0.004) |
| Horisberger (2010) [24] | 9 | Débridement, microfracture | Outerbridge ≥ 2, preoperative radiograph Tönnis ≥ 1 | 20 | 4 F; 16 M | 47 | NR | 1.4 years | 10/20 patients underwent THA Tönnis ≤ 2 less likely to progress to THA than Tönnis > 2 (p = 0.03) Age and Outerbridge score did not affect likelihood of progression to THA |
| 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) |
227 (56) | Group FAI 81 F; 88 M Group FAI OA 13 F; 43 M |
Group FAI 32 Group FAI OA 45 |
NR | 3 years | 1 of 154 progressed to THA in Group FAI 20 of 56 progressed to THA in Group FAI OA Greater JSN predicted increased THA rate (p = 0.014) Greater duration symptoms predicted increased THA rate (p = 0.015) |
| Margheritini (1999) [35] | 9 | Débridement, removal loose bodies, synovectomy | OA diagnosed by radiograph, MRI, or arthroscopy (not specific) | 133 | 87 F; 46 M | 42 | NR | 7 months | 21 of 133 progressed to THA |
| McCarthy (2011) [36] | 13 | Resection, microfracture, removal loose bodies | Outerbridge 0 Outerbridge 1–2 Outerbridge 3–4 |
111 | 64 F; 47 M | 39 | NR | 4.8 years | Overall 10-year survivorship (not having THA) 63% Outerbridge Grade 1–2 10 year survivorship 80% Outerbridge Grade 3–4 10 year survivorship 12% OR needing THA 3.6 times if age > 40 years OR needing THA 20 times if acetabular Outerbridge 3–4 OR needing THA 58 times if femoral Outerbridge 3–4 Overall probability of THA in 10 years if Outerbridge 3–4 = 99% regardless of age |
| Palmer (2012) [44] | 15 | Chondroplasty, microfracture | Outerbridge 0–3 (n = 157) Outerbridge 4 (n = 44) Chondral defects < 1.5 cm2 (n = 201) |
201 (201) | 102 F; 99 M | 40 | 59 months | 46 months | 12/201 patients progressed to THA Significantly more patients with Outerbridge 4 progressed to THA (p = 0.03) |
| Philippon (2009) [46] | 12 | Chondroplasty, microfracture | Joint space measured on preoperative radiograph Outerbridge 1–2 (n = 74)–mild Outerbridge 3 (n = 29)–moderate Outerbridge 4 (n = 9)–poor |
112 | 62 F; 50 M | 41 | 34 months | 16 months | 10 of 112 patients progressed to THA OR progressing to THA 39 times if preoperative joint space < 2.0 mm |
| Wilkin (2014) [57] | 9 | Débridement | Tönnis grading on radiograph | 41 | 31 F; 10 M | 52 | NR | 21.3 months | 6 of 41 patients progressed to THA |
* Mean (SD); OA = osteoarthritis; FAI = femoroacetabular impingement; F = female; M = male; Tönnis = preoperative grading of osteoarthritis using Tönnis scale; Outerbridge = intraoperative grading of chondral injury; NR = not reported.