Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time?

Robinson, Patrick; Liu, Helen; Wilkinson, Tom; Maempel, Julian; Murray, Iain; MacDonald, Deborah; Hamilton, David; Gaston, Paul

Abstract

Background: The purpose of this study was to search for changes in functional outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) between short and medium-term follow-up. Secondary aims included reporting rates of revision surgery and total hip arthroplasty (THA) at medium-term follow-up.

Hypothesis: We hypothesised that patients’ functional outcomes would improve between short and medium-term follow-up.

Patients and Methods: Consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement with labral tears between February 2013 and June 2015 were included. Twelve item international hip outcome tool (iHOT-12) and EuroQol 5D-5L (EQ-5D) scores were collected preoperatively, at short-term and medium-term follow-up. Short-term scores were recorded at a minimum of one year postoperatively and medium-term scores at a minimum of five years postoperatively. Survivorship was assessed with Kaplan-Meier analysis.

Results: Short-term outcome data (at median follow-up 1.6 year, Interquartile range [IQR] 1-2.5) was available for 70 of 87 patients (80.5%) and medium-term outcome data (at median follow-up of 6.5 years, IQR 6-7.1) was available for 68 patients (78.2%). Median age at the time of surgery was 31 years (IQR 25 – 37). The median iHOT-12 scores at short and medium-term follow-up were 72 (IQR 48.75 – 91.25) and 85.8 (IQR 66.7 – 96.7) respectively (p<0.001). Medium-term survivorship was 91.2%. Survivorship following labral repair was 94.2%, and 81.3% following labral debridement (p=0.09).

Discussion: Patients undergoing hip arthroscopy for FAI reported continued improvement in iHOT-12 scores between short and medium-term follow-up. Medium-term survivorship following FAI surgery may be greater when the labrum is repaired, although comparisons are limited by their differing indications. Conversion to THA was low with just 4 patients (4.6%) undergoing or being listed for THA at final follow-up.

Level of Evidence: IV, Case series

Citation

Robinson, P., Liu, H., Wilkinson, T., Maempel, J., Murray, I., MacDonald, D., Hamilton, D., & Gaston, P. (2022). Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time?. Orthopaedics and Traumatology: Surgery and Research, 108(4), Article 103157. https://doi.org/10.1016/j.otsr.2021.103157

• Journal Article Type: Article
• Acceptance Date: Nov 23, 2021
• Online Publication Date: Nov 29, 2021
• Publication Date: 2022-06
• Deposit Date: Dec 7, 2021
• Publicly Available Date: Nov 30, 2022
• Print ISSN: 1877-0568
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 108
• Issue: 4
• Article Number: 103157
• DOI: https://doi.org/10.1016/j.otsr.2021.103157
• Keywords: Femoroacetabular, Impingement, Arthroscopy, Hip, Survivorship
• Public URL: http://researchrepository.napier.ac.uk/Output/2822140