Over 50% of Studies Report Low Back Pain is Associated with Worse Outcomes After Hip Arthroscopy When Compared to a Control Group: A Systematic Review
Purpose: To review outcomes of patients with low back pathology after undergoing primary hip arthroscopy for the treatment of FAIS.
Methods: PubMed, Cochrane Trials, and Scopus were queried in June 2022 to conduct this systematic review using the following terms: ("hip" OR "femoroacetabular impingement") AND ("arthroscopy" OR "arthroscopic") AND ("spine" OR "lumbar" OR "sacral" OR "hip-spine" OR "back") AND ("outcomes"). Articles were included if they reported on patient-reported outcomes and or clinical benefit of patients undergoing hip arthroscopy with concomitant low back pathology. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) criteria. Case reports, opinion articles, review articles, and technique articles were excluded from this study. Forest plots were created to analyze pre - and post-operative outcomes among patients with low back pathology.
Results: Fourteen studies were included in the review. There were 750 hips with low back pathology and FAI (hip-spine syndrome) and 1,800 hips with only FAI (no hip-spine syndrome). All 14 studies reported patient-reported outcomes (PROs). Four studies in the hip-spine group and eight studies in the FAI without low back pathology group reported their respective cohorts achieving the minimal clinically important difference (MCID) at a rate of 80% in at least one PRO. Eight studies reported that patients with low back pathology were associated with inferior outcomes or clinical benefit compared to patients without low back pathology.
Conclusion: Patients undergoing primary hip arthroscopy with concomitant low back pathology can expect favorable outcomes, but outcomes are superior in patients undergoing hip arthroscopy for FAI alone compared to FAI with concomitant low back pathology STUDY DESIGN: Systematic Review of Level II to Level IV studies, Level of Evidence IV; Keywords: Hip Arthroscopy, Hip-Spine, Low Back Pathology, Outcomes.
Lee MS, Mahatme RJ, Simington J, Gillinov SM, Kim DN, Moran J, Islam W, Fong S, Pettinelli N, Lee AY, Jimenez AE. Over 50% of Studies Report Low Back Pain is Associated with Worse Outcomes After Hip Arthroscopy When Compared to a Control Group: A Systematic Review. Arthroscopy. 2023; . doi: 10.1016/j.arthro.2023.05.004.