Hip Arthroscopy in Patients With Generalized Joint Hypermobility Yields Successful Outcomes: A Systematic Review

This purpose of this systematic review was to evaluate the outcomes of hip arthroscopy in patients with generalized joint hypermobility (GJH).A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). . An electronic record search was performed in PubMed, Web of Science, Cochrane library and Embase A two stage title/abstract and full text screening was performed using the following inclusion criteria: 1) observational studies, cohort studies and randomised controlled trials, 2) Describing more than 5 patients with a mean age over 18 years and GJH, 3) undergoing arthroscopy of the hip, 4) Reporting patient reported outcome measures (PROMS), return to sport or complications/re-operations, 5) Published in English.Of the 517 articles identified, 10 studies meeting all selection criteria were included. Included studies report significant improvements in a range of different function and pain-based PROMs. The majority of patients (25.0 - 97.0%) in each study achieved a clinically important improvement post-operatively in at least one PROM. No complications were described in any of the four studies reporting this metric. One study each found an association between GJH and an increased risk of post-operative deep gluteal syndrome and iliopsoas tendinitis. The rate of revision arthroscopy ranged from 0%-11.4% and only two patients in a single study of 11 hips, required conversion to total hip arthroplasty. No statistically significant differences were reported between patients with and without GJH with respect to any of the described outcomes.Patients with GJH may achieve good outcomes following hip arthroscopy with respect to patient reported outcome measures, peri-operative complications, re-operation and return to sport. With effective labral repair and capsular closure, outcomes achieved in patients with GJH are comparable to those reported in patients without hypermobility.Level IV - systematic review of level III-IV studies.