FP15.7 Hip arthroscopy is associated with increased risk of total hip arthroplasty failure and increased resource allocation in middle-aged total hip arthroplasty patients

Abstract

Abstract ICLB15 - The Preservation Scorecard: Fundamentals of Tracking Outcomes and Standardizing Recovery, Session Room 12 (BMCC Level 3), October 9, 2026, 14:00 - 16:00 Purpose Hip arthroscopy rates continue to rise. Although effective, many patients ultimately develop osteoarthritis requiring total hip arthroplasty (THA). Evidence regarding the influence of a prior hip arthroscopy (HA) on subsequent THA outcomes remains limited and conflicting. This study evaluated whether prior HA was associated with increased risk of revision THA in younger patients aged 40–65 years. Secondary objectives included assessment of healthcare utilization and cost before and after THA. Methods A retrospective, population-based cohort study was performed including residents who underwent primary THA for osteoarthritis between 2002 and 2023. Exposure was defined as prior ipsilateral HA, categorized as recent (≤5 years pre-THA) or remote (>5 years). Outcomes included five-year THA revision, 30-day emergency department (ED) visit, hospital readmission, major surgical complication, length of stay, one-year healthcare costs, outpatient orthopedic visits, mortality, and chronic opioid use. Multivariable logistic regression was used to evaluate the association between prior HA and outcomes, adjusting for demographic and clinical factors. Results Among 85,814 primary THA cases, 5,642 (6.6%) had a history of prior HA, including 1,215 performed within five years of THA. Prior HA was associated with greater risk of revision THA (4.9% vs 3.3%). After adjustment, 30-day ED visits, readmissions, and major complications were comparable between groups. Patients with prior HA demonstrated increased pre-THA healthcare utilization and cost, as well as higher one-year post-THA costs and outpatient visit frequency. Chronic opioid use was more prevalent in the HA cohort and independently associated with elevated odds of ED visit (odds ratio [OR] 1.37), readmission (1.61), major complication (1.40), postoperative visits (1.12), and one-year cost (1.47), all p<0.001. Conclusion In adults aged 40–65 years, prior hip arthroscopy was linked to increased risk of revision THA, higher healthcare utilization, and greater associated cost, without a difference in short-term complication or readmission rates. Given advances in modern THA survivorship, hip arthroscopy should be offered judiciously to this age group.