Original Article|Articles in Press

Prior hip arthroscopy increases the risk of dislocation, reoperation, and revision after hip arthroplasty: An updated meta-analysis and systematic review

Published:January 18, 2023DOI:



      The indications for hip arthroscopy have been increasing, as have been the number of patients undergoing total hip arthroplasty (THA) after hip arthroscopy. Several matched cohort studies have assessed the impact of prior hip arthroscopy on THA, but conflicting results have been observed. The purpose of this study was to evaluate the influence of prior arthroscopy on subsequent THA.


      This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 checklist. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library were searched to identify relevant studies. Dichotomous variables were summarized qualitatively as a meta-analysis of pooled odds ratios (ORs) and 95% confidence intervals (CIs), and continuous variables were summarized as standardized mean differences and 95% CIs. P-values <0.05 were considered statistically significant. The risk of bias was evaluated for each study, as was publication bias.


      In patients who underwent hip arthroscopy prior to THA, the ORs for dislocation, reoperation, and revision were 2.02 (P = 0.01), 1.66 (P = 0.01), and 2.15 (P = 0.001), respectively. There were no significant between-group differences in the Harris Hip Score (HHS; P = 0.40), WOMAC (P = 0.069), FJS-12 (P = 0.77), estimated blood loss (P = 0.48), and surgical time (P = 0.16).


      Prior hip arthroscopy is a risk for postoperative dislocation, reoperation, or revision after conversion THA. However, prior hip arthroscopy has no effect on patient-reported outcomes, or operative factors such as surgical time and blood loss.



      total hip arthroplasty (THA), femoroacetabular impingement (FAI)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Orthopaedic Science
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Migliorini F.
        • Maffulli N.
        Arthroscopic management of femoroacetabular impingement in adolescents: a systematic review.
        Am J Sports Med. 2021; 49: 3708-3715
        • Vovos T.J.
        • Lazarides A.L.
        • Ryan S.P.
        • Kildow B.J.
        • Wellman S.S.
        • Seyler T.M.
        Prior hip arthroscopy increases risk for perioperative total hip arthroplasty complications: a matched-controlled study.
        J Arthroplasty. 2019 Aug 1; 34: 1707-1710
        • Hoeltzermann M.
        • Sobau C.
        • Miehlke W.
        • Zimmerer A.
        Prior arthroscopic treatment for femoro-acetabular impingement does not compromise hip arthroplasty outcomes: a matched-controlled study with minimum two-year follow-up.
        Int Orthop. 2019 Jul 4; 43: 1591-1596
        • Zingg P.O.
        • Schallberger A.
        • Rüdiger H.A.
        • Poutawera V.
        • Dora C.
        Does previous hip arthroscopy negatively influence the short term clinical result of total hip replacement?.
        Arch Orthop Trauma Surg. 2012 Mar; 132: 299-303
        • Haynes J.A.
        • Xiong A.
        • Nepple J.J.
        • An T.
        • Nunley R.M.
        • Clohisy J.C.
        Does previous hip arthroscopy affect the clinical outcomes of total hip arthroplasty?.
        Orthop J Sport Med. 2019 Mar 1; 7
        • Charles R.
        • LaTulip S.
        • Goulet J.A.
        • Pour A.E.
        Previous arthroscopic repair of femoro-acetabular impingement does not affect outcomes of total hip arthroplasty.
        Int Orthop. 2017 Jun 1; 41: 1125-1129
        • Viste A.
        • Abdel M.P.
        • Ollivier M.
        • Mara K.C.
        • Krych A.J.
        • Berry D.J.
        Prior knee arthroscopy does not influence long-term total knee arthroplasty outcomes and survivorship.
        J Arthroplasty [Internet]. 2017; 32 (Available from:): 3626-3631
        • Gallazzi E.
        • Morelli I.
        • Peretti G.
        • Zagra L.
        What is the impact of a previous femoral osteotomy on THA? A systematic review.
        Clin Orthop Relat Res. 2019; 477: 1176-1187
        • Yacovelli S.
        • Abdelaal M.
        • Fillingham Y.
        • Sutton R.
        • Madding R.
        • Parvizi J.
        Prior pelvic osteotomy affects the outcome of subsequent total hip arthroplasty.
        J Arthroplasty [Internet]. 2021; 36 (Available from:): 600-604
        • Jain M.V.
        • Rajpura A.
        • Kumar V.S.
        • Shaw D.
        • Najjar M Al
        • Kalsi N.K.
        • et al.
        Functional outcome of total hip arthroplasty after a previous hip arthroscopy: a retrospective comparative cohort study.
        HIP Int. 2019 Jul 1; 29: 363-367
        • Haughom B.D.
        • Plummer D.R.
        • Hellman M.D.
        • Nho S.J.
        • Rosenberg A.G.
        • Della Valle C.J.
        Does hip arthroscopy affect the outcomes of a subsequent total hip arthroplasty?.
        J Arthroplasty. 2016 Jul 1; 31: 1516-1518
        • Konopka J.F.
        • Buly R.L.
        • Kelly B.T.
        • Su E.P.
        • McLawhorn A.S.
        The effect of prior hip arthroscopy on patient-reported outcomes after total hip arthroplasty: an institutional registry–based, matched cohort study.
        J Arthroplasty. 2018 Jun 1; 33: 1806-1812
        • Lindman I.
        • Nåtman J.
        • Öhlin A.
        • Svensson Malchau K.
        • Karlsson L.
        • Mohaddes M.
        • et al.
        Prior hip arthroscopy does not affect 1-year patient-reported outcomes following total hip arthroplasty: a register-based matched case-control study of 675 patients.
        Acta Orthop. 2021; 92: 408-412
        • Parker S.J.M.
        • Grammatopoulos G.
        • Davies O.L.I.
        • Lynch K.
        • Pollard T.C.B.
        • Andrade A.J.
        Outcomes of hip arthroplasty after failed hip arthroscopy: a case-control study.
        J Arthroplasty. 2017 Oct 1; 32: 3082-3087.e2
        • Perets I.
        • Mansor Y.
        • Mu B.H.
        • Walsh J.P.
        • Ortiz-Declet V.
        • Domb B.G.
        Prior arthroscopy leads to inferior outcomes in total hip arthroplasty: a match-controlled study.
        J Arthroplasty. 2017 Dec 1; 32: 3665-3668
        • Spencer-Gardner L.S.
        • Camp C.L.
        • Martin J.R.
        • Sierra R.J.
        • Trousdale R.T.
        • Krych A.J.
        Does prior surgery for femoroacetabular impingement compromise hip arthroplasty outcomes?.
        J Arthroplasty. 2016 Sep 1; 31: 1899-1903
        • Bolarinwa S.A.
        • Aryee J.N.
        • Labaran L.A.
        • Werner B.C.
        • Browne J.A.
        Does arthroscopic repair of femoroacetabular impingement pathology affect clinical outcomes after ipsilateral total hip arthroplasty?.
        Hip Pelvis. 2020; 32: 35
        • Rosinsky P.J.
        • Chen J.W.
        • Shapira J.
        • Maldonado D.R.
        • Lall A.C.
        • Domb B.G.
        Mid-term patient-reported outcomes of hip arthroplasty after previous hip arthroscopy: a matched case-control study with a minimum 5-year follow-up.
        J Am Acad Orthop Surg. 2020 Jun 15; 28: 501-510
        • Nam D.
        • Maher P.
        • Nath T.
        • Su E.P.
        An original study does a prior hip arthroscopy affect clinical outcomes in metal-on-metal hip resurfacing arthroplasty?.
        (Available from:)
        • Bozic K.J.
        • Chan V.
        • Valone F.H.
        • Feeley B.T.
        • Vail T.P.
        Trends in hip arthroscopy utilization in the United States.
        J Arthroplasty. 2013; 28: 140-143
        • Redmond J.M.
        • Gupta A.
        • Dunne K.
        • Humayun A.
        • Yuen L.C.
        • Domb B.G.
        What factors predict conversion to THA after arthroscopy?.
        Clin Orthop Relat Res. 2017; 475: 2538-2545
        • Hevesi M.
        • Leland D.P.
        • Rosinsky P.J.
        • Lall A.C.
        • Domb B.G.
        • Hartigan D.E.
        • et al.
        Risk of conversion to arthroplasty after hip arthroscopy: validation of a published risk score using an independent, prospectively collected database.
        Am J Sports Med. 2021; 49: 1192-1198
        • Piedade S.R.
        • Pinaroli A.
        • Servien E.
        • Neyret P.
        Is previous knee arthroscopy related to worse results in primary total knee arthroplasty? Knee Surgery.
        Sport Traumatol Arthrosc. 2009; 17: 328-333
        • Guo J.
        • Dou D.
        Influence of prior hip arthroscopy on outcomes after hip arthroplasty: a meta-analysis of matched control studies.
        Medicine (Baltim). 2020; 99e21246