Background:

While the indications for primary hip arthroscopic surgery in treating femoroacetabular abnormalities continue to be defined, the indications and outcomes for revision hip arthroscopic surgery remain ambiguous. However, revision hip arthroscopic surgery is performed in 5% to 14% of patients after their index procedure. While patient-reported outcomes (PROs) generally improve after revision procedures, the extent of their improvement is not well defined.

Purpose:

To determine the outcomes and efficacy of revision hip arthroscopic surgery in patients who remain symptomatic after their index procedure.

Study Design:

Meta-analysis and systematic review.

Methods:

The terms “hip arthroscopy,”“revisions,”“outcomes,” and “femoroacetabular impingement” were searched in PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. After screening, 15 studies were included for review. In addition to hip-specific metrics, functional outcome measures were included. Pooled estimates and 95% CIs were calculated using inverse variance methods.

Results:

A total of 4765 hips in 4316 patients were identified. The most common indication for revision surgery was inadequate bony resection during the index procedure. Meta-analysis showed that all PROs improved significantly from baseline to final follow-up after revision hip arthroscopic surgery. Notably, the modified Harris Hip Score (mHHS) increased a mean of 17.20 points after revision hip arthroscopic surgery, the Hip Outcome Score–Activities of Daily Living (HOS-ADL) improved by 13.98, and the visual analog scale (VAS) for pain decreased by 3.16. However, when compared with primary hip arthroscopic surgery, the mean PRO scores after revision hip arthroscopic surgery were lower. After revision hip arthroscopic surgery, the rates of conversion to total hip arthroplasty ranged from 0% to 14.3%, and the rates of further arthroscopic revision ranged from 2% to 14%.

Conclusion:

Inadequate bony resection represents the most common indication for revision hip arthroscopic surgery. PROs improve significantly after revision hip arthroscopic surgery but remain lower than those of patients undergoing primary hip arthroscopic surgery.

中文翻译：

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翻修髋关节镜手术的结果：系统评价和荟萃分析。

背景：

尽管治疗髋臼髋关节异常的原发性髋关节镜手术适应症仍在确定，但翻修髋关节镜手术的适应症和结局仍然不明确。但是，在进行分度手术后，有5％至14％的患者进行了翻修髋关节镜手术。虽然患者报告的结局（PRO）通常在修订程序后有所改善，但其改善程度尚不确定。

目的：

为了确定在进行索引手术后仍对症的患者的翻修髋关节镜手术的结果和疗效。

学习规划：

荟萃分析和系统评价。

方法：

在PubMed，Web of Science，Scopus，Cochrane Library和Google Scholar中搜索了“髋关节镜”，“修订”，“结果”和“髋臼前突”​​。筛选后，纳入15项研究进行审查。除了特定于髋关节的指标外，还包括功能结局指标。使用逆方差方法计算汇总估计值和95％CI。

结果：

在4316名患者中，总共鉴定了4765髋。翻修手术最常见的指征是在分度手术期间骨切除不足。荟萃分析显示，从翻修髋关节镜手术后到基线随访至最终随访，所有PRO均显着改善。值得注意的是，经过修订的髋关节镜手术后，改良的Harris髋关节评分（mHHS）平均提高了17.20分，髋关节成果评分-日常生活活动能力（HOS-ADL）提高了13.98，视觉模拟疼痛评分（VAS）减少了3.16。然而，当与原发性髋关节镜手术相比时，翻修后的髋关节镜手术的平均PRO评分较低。翻修髋关节镜手术后，全髋关节置换术的转化率为0％至14.3％，

结论：

骨切除不足是翻修髋关节镜手术的最常见指征。翻修髋关节镜手术后，PROs显着改善，但仍低于接受初次髋关节镜手术的患者。