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Hip Spine Syndrome Negatively Impacts Arthroscopic Outcomes in the Management of Femoroacetabular Impingement Syndrome: A Systematic Review

      Abstract

      Purpose

      To determine whether the presence of spine pathology affects clinical outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in the setting of hip-spine syndrome (HSS).

      Methods

      A systematic review of PUBMED and Cochrane was conducted. Primary research articles evaluating patient-reported outcomes (PRO) after hip arthroscopy for FAIS in the presence of concomitant spine pathology were considered.

      Results

      Literature review identified twelve studies meeting criteria. In 2109 FAIS patients undergoing hip arthroscopy, 591 had concomitant spine pathology. Baseline PROs in the hip-spine (mHHS: 39.8–65.29 versus 56.9–78.8, 8 studies; NAHS: 42.2–51.5 versus 68.2–75.2, 4 studies; HOS-ADL: 45.9–71.1 versus 49.3–89.51, 9 studies; HOS-Sport: 22.8–49.6 versus 50.6–73.1, 3 studies; iHOT-12: 38.0 versus 66.0, 1 study; VAS Pain: 6.43–6.56 versus 1.18–3.60, 3 studies; VAS Satisfaction: 7.18–7.46 range at follow up, 2 studies) and control (mHHS: 39.3–64.9 versus 70.2–92.6, 6 studies; NAHS: 42.8–54.2 versus 74.0–87.1, 4 studies; HOS-ADL: 59.0–76.4 versus 75.4–97.1, 4 studies; HOS-Sport: 38.1–55.1 versus 60.9–93.9, 3 studies; iHOT-12: 43.4 versus 89.8, 1 study; VAS Pain: 6.18–6.22 versus 1.82–3.44, 2 studies; VAS Satisfaction: 7.74–8.22 range at follow up, 2 studies). Minimal clinically important difference threshold rates achieved in the hip-spine (44.1–86.7, 4 studies) cohorts were significantly lower than control (79.4–88.2%; 4 studies) cohorts in 3 studies. Patient acceptable symptomatic state threshold rates achieved in the hip-spine (42–63.5, 3 studies) cohorts were significantly lower than control (58.8–81.0, 3 studies) in 1 study. There was no statistical difference in complication and re-operation rates between cohorts.

      Conclusion

      FAIS patients with concomitant HSS have improved but inferior outcomes after hip arthroscopy compared to patients without HSS.

      Keywords

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