The popularity of minimally invasive hip surgery is booming, but this procedure may not be the best option for people over 60 years old or those with arthritis, a new study finds.
Serious hip pain is one of the most common causes of chronic pain in the U.S. Although it’s difficult to estimate the number of sufferers, approximately 116 million Americans deal with chronic pain and an estimated 2.5 million people have undergone total hip replacements, statistics say.
According to researchers at the Hospital for Special Surgery in Manhattan, the number of people opting for arthroscopic hip surgery over conventional hip replacement grew 600 percent between the years 2006 and 2010 alone.
In arthroscopic, or minimally invasive hip surgery, the surgeon makes two incisions, pushes aside the hip muscle, rather than cutting it, and replaces the hip’s “ball” and “socket” with titanium implants. This procedure halves hospitalization and recuperation time compared to conventional hip replacement surgery.
But after analyzing about 7,300 patient cases in databases from California and Florida, the researchers discovered that more than one-third of the patients ages 60 to 69 went on to have a total hip replacement within two years of arthroscopic hip surgery, according to the study, published in Arthroscopy: The Journal of Arthroscopic and Related Surgery.
Only 3 percent of patients younger than 40 went on to have a hip replacement, compared to 35 percent of patients who were 60 to 69, the age group more likely to have arthritis. In addition to arthritis, obesity was found to be a major risk factor for needing a hip replacement within two years, the study found.
Ten years ago, arthroscopic surgery was not a very common procedure, says Dr. William Schairer, the study’s lead author. However, of the years, the technology has improved, a lot more surgeons are trained to do perform it, and many more patients are requesting it. As a result, the surgery is being performed on people who are not appropriate candidates, he says.
"There is growing concern regarding the efficacy of hip arthroscopy in patients with pre-existing hip arthritis," Schairer says. "Previous smaller studies have also noted a worse prognosis in these patients, with most advising against hip arthroscopy in patients with more than mild arthritis."
"This is important information for patients and surgeons so they can have a real discussion about what types of treatments would be most beneficial in the long run based on a patient's individual circumstances,” he adds.
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