This PRISMA-compliant systematic review of 13 studies (1,571 hips, follow-up 5–20 years) asks whether the functional gains seen after hip arthroscopy hold up over time. It also examines rates of revision surgery and THA conversion, and identifies which preoperative factors predict failure.
The two questions every hip arthroscopy patient asks are: "Will I feel better?" and "Will I still need a hip replacement?" This review gives you the data to answer both honestly. PRO gains are real and durable through at least 5 years. But THA conversion is not rare — quote your patients a 3%–18% chance at 5 years, rising to as high as 32% by 10 years depending on their baseline joint status.
The most actionable take: screen for OA and cartilage damage before offering arthroscopy. Patients with Tönnis grade 2 or age >35 need an explicit conversation about realistic expectations. If you find the labrum is repairable intraoperatively, repair it. The long-term survivorship data strongly favor repair over debridement, and the difference widens with every year of follow-up.
The authors note that 20-year conversion rates likely overestimate modern risk, since most of those cohorts reflect the debridement era before labral repair became standard practice.
This PRISMA-compliant systematic review of 13 studies (1,571 hips, follow-up 5–20 years) asks whether the functional gains seen after hip arthroscopy hold up over time. It also examines rates of revision surgery and THA conversion, and identifies which preoperative factors predict failure.
The two questions every hip arthroscopy patient asks are: "Will I feel better?" and "Will I still need a hip replacement?" This review gives you the data to answer both honestly. PRO gains are real and durable through at least 5 years. But THA conversion is not rare — quote your patients a 3%–18% chance at 5 years, rising to as high as 32% by 10 years depending on their baseline joint status.
The most actionable take: screen for OA and cartilage damage before offering arthroscopy. Patients with Tönnis grade 2 or age >35 need an explicit conversation about realistic expectations. If you find the labrum is repairable intraoperatively, repair it. The long-term survivorship data strongly favor repair over debridement, and the difference widens with every year of follow-up.
The authors note that 20-year conversion rates likely overestimate modern risk, since most of those cohorts reflect the debridement era before labral repair became standard practice.