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., …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