Authors' objectives:

This study aims to assess the usefulness of arthroscopy in hip pathologies.

Authors' results and conclusions: For this report narrative revisions and case series were used. No other observational designs or randomized controlled clinical trials were detected, neither documents that set position on the topic, published by the main national or international orthopedic associations. Two case series of 40 and 102 patients compare hip arthroscopy (HA) with other diagnostic alternatives such as Magnetic Resonance arthrography (MRA), magnetic resonance imaging (MRI) with contrast and anesthetic injection within the coxofemoral joint. In both series the other methods validity was calculated against HA, which was used as reference test for the possibility it offers to directly explore the joint. The case series generally report therapeutic indications. One common application is the resection of labrum flaps. Approximately two thirds of the patients in most revised series report a symptomatic improvement after surgery. Foreign or loose body removal is another recognized application, since it decreases the risk of avascular necrosis. Debridement for septic arthritis in children and adults, using this technique has clear advantages over open surgery. With respect to its usefulness as diagnostic test, it was reported that patients with chronic pain (6 months or more) with negative radiologic studies would benefit from HA, since in half of the cases treatable pathologies were found. It is also useful to make a differential diagnosis between arthrosis and inflammatory disease, chondrocalcinosis, villonodular synovitis, and chondromatosis.

Authors' recommendations: In comparison with other diagnostic alternatives, HA is more specific and sensitive than Magnetic Resonance arthrography, MRI with gadolinium and response to intraarticular anesthetics. In the studies found, HA was used as the reference test. The most frequent uses are related to minimally invasive surgeries. HA renders better results on a functional assessment and pain scale for indications such as removal of loose bodies, labrum lesions (tears, flaps) and infectious arthritis (Debridement and lavage). Other conditions may also benefit from arthoscopic treatment. In pediatrics is a less invasive technique than traditional ones and leads to a faster recovery. Besides, the risk of bone necrosis is less. It is mainly used for septic arthritis. Other applications are Legg-Calv -Perthes disease and hip dysplasia. The use of this technology only for diagnostic purposes declined over years, probably because there are better imaging diagnostic tools. With respect to HA replacing conventional surgical procedures, no results have been published so far of long term follow-up studies. However, although the evidence identified is of low quality, there is consensus among specialists on its efficacy for the indications already described.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.iecs.org.ar/

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)