Purpose
To determine the relationship of increased femoral anteversion and borderline acetabular
dysplasia on the outcomes of hip arthroscopy for femoroacetabular impingement in a
female cohort of patients.
Methods
This is a retrospective study of female patients undergoing hip arthroscopy for femoroacetabular
impingement. All patients had preoperative radiographs and computed tomography scans
from which lateral center edge angle (LCEA) and femoral anteversion were measured.
Patient outcome was quantified by preoperative and postoperative International Hip
Outcome Tool 12-item instrument (iHOT-12). All patients had follow-up at 2 to 4 years
postoperatively. Published values for minimum clinically important difference, substantial
clinical benefit (SCB), patient acceptable symptomatic state (PASS), and a normal
or abnormal hip were used to determine outcome as well as the final score and delta
of the iHOT-12.
Results
There were 243 female patients included in the cohort (83% follow-up) who had iHOT-12
scores at 2- to 4-year follow-up (mean 36.9 months). Female patients with combined
LCEA ≤25° and femoral anteversion >20° had lower final IHOT-12 scores (P = .001) and delta iHOT-12 (P = .010) and were less likely to achieve a normal hip (P = .013), minimum clinically important difference (P = .018), SCB (P < .001), or PASS (P < .001) and more likely to have an abnormal hip (P = .002). In addition, patients with an LCEA ≤25° and normal femoral version were
less likely to achieve a normal hip (P = .013), SCB (P < .001), and PASS (P < .001) compared with those with normal acetabular coverage (all P < .05). There was no difference in these outcome measures between the groups with
an LCEA >25° with or without increased femoral version.
Conclusions
Female patients with femoral anteversion >20° and borderline acetabular dysplasia
did poorly after hip arthroscopy. However, those with increased femoral anteversion
and normal acetabular coverage had outcomes similar to control hips.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Published online: November 01, 2022
Accepted:
October 20,
2022
Received:
March 27,
2022
Footnotes
See commentary on page 978
The authors report the following potential conflicts of interest or sources of funding: H.S.W. reports personal fees from Linvatec, Mitek, and Stryker, outside the submitted work. In addition, H.S.W. also has a patent for labral repair anchor pending. J.D.W. reports board or committee member, American Orthopaedic Society for Sports Medicine; and editorial board, Arthroscopy. ICMJE author disclosure forms are available for this article online, as supplementary material.
Institution where study performed: The Orthopedic Specialty Hospital, Intermountain Healthcare, Murray, Utah, U.S.A.
Identification
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© 2022 by the Arthroscopy Association of North America
