Revision Hip Arthroscopy Yields Inferior Patient Reported Outcome Measures and Patient Acceptable Symptomatic State Along with Higher Total Hip Arthroplasty Conversion Compared to the Primary Setting at a Minimum 2-Year Follow-Up
Bibliographic record
Abstract
PURPOSE: To compare functional and patient-reported outcomes between primary and revision hip arthroscopy. METHODS: A systematic search was conducted using 3 databases (PubMed, EMBASE, CINAHL) from inception to October 2024, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Only comparative clinical studies evaluating primary versus revision hip arthroscopy with minimum 2-year follow-up were included. Evaluated outcomes included patient-reported outcome measures, reoperation/total hip arthroplasty conversion rates, and patient-acceptable symptomatic state (PASS)/minimal clinically important difference (MCID) achievement rates. RESULTS: Nine studies were retrieved for analysis. In total, 2,128 and 723 patients (2,230 and 737 hips) were included in the primary and revision setting, respectively. Femoroacetabular impingement and labral-related procedures were reported in all patients. At a minimum 2-year follow-up, Hip Outcome Score Activities of Daily Living and Sports Subsection scores ranged from 77 to 87.4 and 57 to 91.7 in the primary and from 77.6 to 80.4 and 54.4 to 65.3 in the revision groups, respectively. Moreover, modified Hip Harris Score and International Hip Outcome Tool 12 scores presented lower ranges in the revision setting, upon comparison with the primary cohort (72.2-81 vs 80-96 and 59.4-63.7 vs 71.9-91.5, respectively). Furthermore, revision/repeat revision ranged from 0-12.5% in the primary and 0-14.2% in the revision cohort. Conversion to total hip arthroplasty varied from 0 to 12.6% in the primary and from 0 to 27.5% in the revision arm. PASS threshold achievement rates were higher in the primary hip arthroscopy group in 3 of the 4 studies that reported them (55.8-71.1% vs 29.4-80.6%). CONCLUSIONS: Patients undergoing revision hip arthroscopy achieve inferior functional outcomes, reflected in patient reported outcome measures and PASS achievement rates, compared to the primary setting. No apparent revision or repeat revision arthroscopy differences were observed; however, the revision cohort trended toward higher total hip arthroplasty conversions. These results support our hypothesis regarding inferior outcomes and higher conversion rates in revision cases. LEVEL OF EVIDENCE: III, systematic review of Level II-III studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.009 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".