Purpose
To report minimum 2-year patient-reported outcome measures (PROMs) following primary
hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and painful external
snapping hip (ESH) treatment and ESH resolution, and to compare these PROMs to a benchmark
FAIS propensity-matched control group without ESH.
Methods
Data were prospectively collected and retrospectively reviewed between November 2009
and April 2018. Patients were eligible if they were preoperatively diagnosed with
FAIS and painful ESH and received primary hip arthroscopy to address these pathologies.
ESH was treated with gluteus maximus and iliotibial band releases. Inclusion criteria
were baseline and minimum two-year follow-up scores for the modified Harris Hip Score,
Nonarthritic Hip Score, Hip Outcome Score-Sport Specific Subscale, and visual analog
scale for pain. Exclusion criteria were Tönnis grade >1 and previous hip conditions.
A secondary subanalysis was performed to benchmark these outcomes to a FAIS propensity-matched
control group without ESH, according to age, sex, body mass index (BMI), Tönnis grade,
and preoperative lateral center-edge and α-angles using a 1:3 ratio. The minimal clinically
important difference (MCID) and the maximum outcome improvement (MOI) rates were reported.
Results
Twenty-two hips (21 patients) were included. The mean age, BMI, and follow-up were
31.3 years ± 14.0, 26 kg/m2 ± 5.0, and 31.4 months ± 4.4, respectively, with 68.2% being female. ESH was resolved
in 100% of patients. Significant improvement for all PROMs at a minimum two-year (P < .001) was reported. The minimum two-year PROMs and the rate of achieving the MCID
and MOI threshold were comparable to the control group.
Conclusion
Following primary hip arthroscopy for FAIS and painful ESH, patients demonstrated
significant improvement in all PROMs, and the rate of resolution of ESH was 100% at
minimum two-year follow-up: with gluteus maximus and iliotibial band releases. Functional
outcomes and rates of MCID and MOI achievement were comparable to a FAIS propensity-matched
benchmark control group without ESH.
Level of Evidence
Level III, retrospective comparative study.
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Article Info
Publication History
Published online: December 14, 2021
Accepted:
November 30,
2021
Received:
May 26,
2021
See commentary on page 1900Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.R.S. reports grants from Arthrex and personal fees from DJO Global, outside the submitted work. D.R.M. reports nonfinancial support from Arthrex , Stryker , Smith & Nephew, and Ossur , outside the submitted work. D.R.M. is an editorial board member of the Journal of Arthroscopy. A.C.L. reports grants and personal fees and nonfinancial support from Arthrex , nonfinancial support from Iroko , nonfinancial support from Medwest , nonfinancial support from Smith & Nephew, grants and nonfinancial support from Stryker , nonfinancial support from Vericel , nonfinancial support from Zimmer Biomet , personal fees from Graymont Medical, outside the submitted work. Dr. Lall is the Medical Director of Hip Preservation at St. Alexius Medical Center and the Clinical Instructor at the University of Illinois College of Medicine. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2021 by the Arthroscopy Association of North America
