Hip Arthroscopy Recovery? Unlikely If You’ve Lost Half of Your Hip Cartilage…

By /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

Hip Arthroscopy Recovery

Hip arthroscopy has been all the rage lately. Many patients are getting offered this invasive surgery with various amounts of hip arthritis because their MRI shows evidence of impingement. Their focus is hip arthroscopy recovery, or a rapid return to their activities once they heal from surgery. However, a new paper published on registry data shows that many patients undergoing the surgery are less likely to recover if they have even moderate arthritis.

The paper looked at 153 patients who were older than 50 who had undergone hip arthroscopy for FAI (hip impingement) and the results of the 42% of them who were available for long-term follow-up. The analysis of the data showed that if the patient had at least 2 mm of cartilage remaining in the joint, they did well. However, if they had less than 2 mm of cartilage, they did poorly. While 2 mm of cartilage sounds like the patients who did poorly were “bone on bone”, that’s not really the case. The normal amount of cartilage in the human hip is only 3.61-3.63 mm. So if you had lost half of your hip cartilage, you did poorly with hip arthroscopy to treat impingement. Also to put this in perspective, what would the outcome have been if we just left this hip arthritis alone? For this study that’s tough to say, but we can use another large study to get a rough idea. A study in 2011 out of Iceland looked at the x-rays of nearly 3,000 hips and defined hip arthritis as having 2.5 mm of cartilage or less. Surprisingly, 11-28 years later, despite a socialized healthcare system, more than 4 in 5 patients with 2.5 mm of cartilage or less (arthritis) had not gotten a hip replacement! Patients with 2 mm or less of cartilage in this hip surgery study got a hip replacement about 2 in 5 times, more frequently than the study in Iceland. One could argue that this is because of their hip impingement, but since recent studies show that many patients with normal hips meet the definition of hip impingement on imaging, it’s a good bet that many of the patients in the Iceland study had impingement (or the bigger issue, dysplasia-a short hip socket).

Is Fixing Hip Impingement a Good Idea? Are Those Bone Spurs Preventing Arthritis?

The upshot? Most patients over age 50 who get a MRI for disabling hip pain and are later diagnosed with impingement have less than 2 mm of hip cartilage. Based on this study, those patients are not good candidates for hip arthroscopy. Despite this study, we continue to see many of these moderate arthritis patients operated to treat the impingement. In addition, since less than 2 in 10  patients in this general category never opt for a hip replacement naturally, one has to ask the question why 4 in 10 patients are opting for an early hip replacement after hip arthroscopy when the “impingement” has been removed surgically? Could it be that the bone spurs we’re removing are protective? Indeed, at least based on one well done study on hip impingement this seems to be the case. The bone spurs that surgeons believed were a cause of arthritis were actually protecting the joint from more arthritis. So should we remove these protective bone spurs? Not IMHO.

Category: Hip, Latest News

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.

LinkedIn
Email