• Dr. Domb!

    Thanks a lot for getting my hip right. Looking forward to a full recovery and a great season. Thanks again for everything.

    Corey WoottonChicago Bears and Detroit Lions
  • Thank you for all that you have done for me and the team. My hip feels so much better, and because of you I'm pain free.
    Sylvia Fowles WNBA Finals MVP, 2-time Olympic Gold Medalist
  • Thank you for working your magic! You're the best!
    Zakiya BywatersChicago Red Stars, National Women's Soccer League
  • Thanks for all the love and positive Energy that was put into my surgery. May the Lord bless you and your family.
    Atari BigbyGreen Bay Packers and San Diego Chargers
  • Dr. Domb, Thanks for fixing me up
    Rashied DavisChicago Bears
  • Huge thank you to Dr. Domb for always taking care of me and getting me back on the court in no time!
    Elena Delle DonneChicago Sky, MVP of the WNBA
  • Dr. Domb! Thanks for taking care of the hip! All the best to you and your staff
    Roosevelt ColvinChicago Bears' All-Decade Defense team
  • Thanks doc for fixing my hip!
    Ryan ChiaveriniWindy City Live Co-Host on ABC7

2014- Domb et al. How Much Arthritis is too Much for Hip Arthroscopy: A Systematic Review. Arthroscopy.

Purpose: The purpose of this study was to determine the extent of preoperative osteoarthritis (OA) that precludes benefit from hip arthroscopy by systematically reviewing the literature on hip arthroscopy in the setting of OA.

Methods: We searched the Medline and PubMed databases using the following Medical Subject Heading terms: arthritis, osteoarthritis, chondral damage, chondral injury, chondral delamination, and hip arthroscopy. Two authors independently reviewed the literature and included articles if they were in the English language; commented on preoperative factors, parameters, physical examination, or diagnostic testing that may be evidence of cartilage damage and/or arthritis; contained outcome data on patients undergoing hip arthroscopy; and had a sample size of at least 10 patients with arthritic changes in the hip. We excluded review articles, technique articles, articles with overlapping patient populations, articles with hip arthroscopy used as an adjunct to an open procedure, articles with inflammatory and septic arthritis, and articles with a mean age younger than 18 years.

Results: Our search identified 518 articles, of which 15 met the inclusion and exclusion criteria. Two thousand fifty-one hips underwent arthroscopy at a mean patient age of 40.2 years. Of these, 1,195 hips had signs of OA. There were 345 conversions to total hip arthroplasty/surface replacement arthroplasty. Of these patients, 274 had OA. Eight patient-reported outcome instruments were used. Factors influencing outcomes were preoperative OA, age, chondral damage, femoroacetabular impingement, and duration of symptoms.

Conclusions: Current evidence is insufficient to define a cutoff for how much arthritis is too much for hip arthroscopy. However, this analysis shows that patients with a Tönnis grade of 1 or greater or a joint space of 2 mm or less are less likely to benefit from hip arthroscopy and more likely to require conversion to total hip arthroplasty/surface replacement arthroplasty. Postoperative scores on patient-reported outcome instruments are lower in the arthritic population at follow-up compared with their nonarthritic counterparts.

Level of Evidence: Level IV, systematic review of Level III and IV studies.

Click here to download the complete publication