ing total hip arthroplasty. Arthroscopy is only an alternative to hip replacement, not a procedure to be considered for milder symptoms associated with the disease. This is important for two reasons. First, if an adequate response is not achieved, the patient must be prepared for whether he or she is subsequently ready to consider hip replacement. Second, some patients are able to live in a delicate equilibrium with the underlying degenerative changes for years. There is always the risk that attempted arthroscopic de-bridement may aggravate the process and inadvertently accelerate the need for arthroplasty.
A moderately successful result of arthroscopic de-bridement can only be gauged as some improvement for some length of time. The subjective gauge is whether improvement is adequate enough to be satisfactory to the patient and of sufficient duration to have been deemed worthwhile. Jackson reports that arthroscopic debridement for degenerative disease of the knee results in approximately an 80% likelihood of some improvement.51 With proper patient selection, it is hoped that this percentage could be approached for the hip. Thus far, published results of ar-throscopy for arthritis of the hip remain inferior to those of the knee. Sampson (personal communication) attributes this inability to achieve comparable results between the knee and hip to the differences in the joint architecture. The knee is a tricompartmental joint, whereas the hip is a unicompartmental joint. Patients can selectively unload the medial or lateral
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