Researchers urge caution for arthroscopic debridement of labral tears in older patients

Wilkin G. J Bone Joint Surg. 2014;doi:10.2106/JBJS.L.01710.

Arthroscopic acetabular labral debridement in patients aged 45 years or older was linked with a 17% reoperation rate at a mean of 21.3 months and minimal overall improvement in joint-specific outcome measures, according to researchers with The Ottawa Hospital in Ottawa.

Geoffrey Wilkin, MD, and colleagues studied the WOMAC, SF-12 and modified Harris Hip Scores (mHHS) of 41 patients who were at least 45 years of age at the time of arthroscopic acetabular labral debridement.

There were seven reoperations, of which six involved conversion to hip arthroplasty or resurfacing. Study results showed the hip arthroscopy group showed improvements ranging from 15.4 points to 6.1 points in their mean WOMAC pain and function scores, SF-12 physical component summary score and mHHS. However, changes in the WOMAC stiffness and SF-12 mental component summary scores were not significant. Postoperative mHHS showed good or excellent outcomes in 13 patients.

“The results in the present series of patients suggest that arthroscopic labral debridement has a much lower overall clinical benefit in patients who are 45 years of age or older than in younger patients,” the researchers wrote in their study. “Since it remains difficult to predict which patients are likely to derive clinical benefit and since the overall benefit was small, arthroscopic debridement of acetabular labral tears in older patients should be approached with caution.”

Disclosure: Beaule is a consultant for Medacta, CORIN, Smith & Nephew, Maquet and Wright Medical Technology. He received royalties from CORIN, Medacta and Wright Medical Technology, stock options from Wright Medical Technology and travel accommodations from CORIN, Medacta and Smith & Nephew.

Artroscopia y ortopedia

Artroscopia y ortopedia

lunes, 27 de enero de 2014