Tomer Ben Tov1, Eyal Amar1, Oren Tsvieli2, Guy Morag3, Moshe Salai1, 3, Ehud Rath1

1. Minimal Invasive Surgery Unit, Division of Orthopedic Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

2. Orthopedic department, Soroka University Medical Center, Beer Sheva, Israel

3. Sport Medicine Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

HIP ARTHROSCOPY: LABRAL REPAIR IN PATIENTS OLDER

THAN 50 YEARS OLD

HIP ARTHROSCOPY: LABRAL REPAIR IN PATIENTS OLDER

THAN 50 YEARS OLD

• None of the authors have a conflict of interest.

• None of the following exist:

• Royalties and stock options.

• Consulting income.

• Research and education support.

• Other support.

INTRODUCTION: • Femoroacetabular impingement is a recognized etiology of intra-

articular pathology and subsequent osteoarthritis in adults.

• Arthroscopy has been useful in the management of hip pathologies and has been proposed as a method of correcting the underlying impingement as a cause of late OA.

• The purpose of this study is to report the results of our early experience in the arthroscopic management of femoroacetabular impingement and arthroscopic labral repair in patients older than 50 years old.

METHODS: • Cohort of 22 patients older than 50 years. • January 2010 to January 2012. • Single surgeon. • All patients prospectively assessed with a Modified Harris Hip

Score. • 20/22 patients had Hip Outcome Score.

METHODS: • The mean age was 58 years (range, 50 to 75 years).

• 16 female and 6 male patients.

Patient # Age Sex Side Preop. MHHS Preop. Function Preop. HOS Postop. MHHS Postop. Function Postop. HOS

1 52 F L 30.8 no data 33 10% improvement no data

2 51 F R 60.4 10% 32.8 95.6 60% 89.1

3 55 F L 59.3 10% 39 92.3 80% 64.3

4 67 F R 36.3 30% 16.1 95.6 100% 100

5 54 F L 86.8 50% 64.7 100 90% 95

6 60 M R 87.9 65% 85.9 100 85% 100

7 62 F L 71.4 50% 44.6 92.3 80% 82.1

8 57 M R 68.1 55% 84.4 94.5 60% 95.3

9 63 M L 75.8 30% 72 91.2 75% 83.3 10 52 M L 53.8 40% 46.7 74.7 65% 71.9 11 61 M L 53.8 50% no data 53.8 50% no data

12 51 F L 67 50% 61.7 95.6 90% 91.7

13 50 F R 41.8 40% 23 57.1 60% 79

14 53 F L 87.9 60% 90.3 87.9 60% 90.3

15 56 F L 31.9 20% 35.5 55.6 50% 56.6

16 63 M R 58.2 50% 44.1 91.2 70% 85.5

17 60 F R 56 40% 69.7 56 40% 69.7

18 75 F L 45.1 50% 56.0 79.1 80% 89.7

19 64 F L 54.9 50% 26.4 95.6 70% 90.6

20 66 F R 58.2 60% 64.5 95.6 80% 90.6

21 52 F R 68.1 70% 72.1 95.6 90% 90.6

22 52 F R 59.3 60% 59.2 100 90% 86.8

Labral tear in 60 y.o female

Labral tear in 54 y.o female

Acetabuloplasty + labral repair

RESULTS: • All the patients report improvement of pain and function after the

surgery. • Mean Modified Harris Hip Score improvement was 23.6 points

(from 59.7 preop. to 83.3 postop.). • Mean Hip Outcome Score improvement was 30.7 points (from

54.4 preop. to 85.1 postop.). • A mean of 27% increase in the level of function during usual

activities of daily living.

MODIFIED HARRIS HIP SCORE:

0

20

40

60

80

100

PRE-OP POST-OP

MHHS

HIP OUTCOME SCORE:

0

20

40

60

80

100

PRE-OP POST-OP

HOS

CONCLUSIONS: • Arthroscopic management of femoroacetabular Impingement

and labral repair in patients older than 50 years is associated with significant improvement in outcome at most recent follow-up.

• Because of the potential important rule of the labrum for long term hip joint integrity we advocate preservation of the labrum when surgically managing FAI in patients older than 50.

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