{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T14:14:04Z","timestamp":1778249644860,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,17]],"date-time":"2025-05-17T00:00:00Z","timestamp":1747440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To characterize risk factors for patients who underwent multiple\u2010revision hip arthroscopies and report survivorship at a minimum 2 years after hip arthroscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients aged 18\u201065 years who underwent revision hip arthroscopy between January 2011 and September 2018 with \u22652\u2010year follow\u2010up were included. Exclusion criteria were age &lt;18 or &gt;65 years at time of surgery, center\u2010edge angle &lt;20\u00b0, previous ipsilateral periacetabular osteotomy, or refusal to participate. Procedures were categorized as first (R1), second (R2), or third or more (R3+) revisions. Demographics, preoperative radiographic measurements, baseline patient\u2010reported outcomes (PROs), intraoperative findings, and survivorship were compared across groups and between those requiring further surgery or total hip arthroplasty (THA) and those who did not. Survivorship was defined as re\u2010revision and arthroplasty\u2010free survival. PROs included modified Harris Hip Score, Hip Outcome Score \u2013 Activities Daily Living, HOS\u2010Sport, Western Ontario and McMaster Universities Osteoarthritis Index, and Short Form Physical and Mental Component Scores (12\u2010Item Short Form Physical Component Score\/Mental Component Score).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 284 hips (246 patients) met inclusion criteria, with mean follow\u2010up of 4.3 \u00b1 2.1 years. Female sex (52% vs 63% vs 78%,\n                      <jats:italic>P<\/jats:italic>\n                      = .03), primary hip arthroscopy at an outside institution (62% vs 78% vs 96%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), smaller alpha angle (64\u00b0 vs 56\u00b0 vs 50\u00b0,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and worse baseline PROs (modified Harris Hip Score, Hip Outcome Score \u2013 Activities Daily Living, HOS\u2010Sport, Western Ontario and McMaster Universities Osteoarthritis Index;\n                      <jats:italic>P<\/jats:italic>\n                      = .05,\n                      <jats:italic>P<\/jats:italic>\n                      = .01,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001,\n                      <jats:italic>P<\/jats:italic>\n                      = .01) were associated with more previous revisions. Failure incidence did not differ between groups (\n                      <jats:italic>P<\/jats:italic>\n                      = .29), but the hazard ratio for further surgery or THA was greater for R3+ versus R1 (hazard ratio 2.4, 95% confidence interval 1.04\u20105.38,\n                      <jats:italic>P<\/jats:italic>\n                      = .04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At a minimum 2\u2010year follow\u2010up, more prior revisions were associated with female sex, lower baseline PROs, capsular deficiency, and greater failure risk. Patients with lower nondysplastic lateral center\u2010edge angles, severe acetabular cartilage damage, or \u22653 revisions had elevated risk for re\u2010revision or THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, therapeutic case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2025.101166","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T19:50:12Z","timestamp":1747857012000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three or More Revision Hip Arthroscopy Surgeries Is More Common in Female Patients and High\u2010Grade Acetabular Chondral Lesions Lead to Increased Risk of Failure"],"prefix":"10.1002","volume":"7","author":[{"given":"Joseph J.","family":"Ruzbarsky","sequence":"first","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spencer M.","family":"Comfort","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera M.","family":"Stetzelberger","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin J.","family":"Ernat","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas A.","family":"Felan","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant J.","family":"Dornan","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc J.","family":"Philippon","sequence":"additional","affiliation":[{"name":"Steadman Philippon Research Institute Vail Colorado U.S.A."},{"name":"Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport Vail Colorado 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}],"article-number":"101166"}}