Purpose
To report minimum 2-year follow-up patient-reported outcome scores (PROs) and rates
of achieving the minimal clinically important difference (MCID), the patient-acceptable
symptomatic state (PASS), and the maximal outcome improvement (MOI) on adolescents
following primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
Second, to determine risk factors for revision surgery.
Methods
Prospectively collected data from two high-volume hip arthroscopy centers were retrospectively
reviewed on adolescents (≤19 years old) who underwent primary hip arthroscopy between
November 2008 and February 2019. Adolescents with a minimum 2-year follow-up for the
modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports
Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), and visual
analog scale (VAS) for pain were included regardless of their growth plate status.
Exclusion criteria were Tönnis grade >1, lateral center edge-angle <18°, and previous
ipsilateral hip surgery or conditions. Preoperative and postoperative radiographic
data, MCID, PASS, MOI, secondary surgeries, and complications were reported. A multivariable
survival analysis for risk factors for secondary surgery was conducted.
Results
A total of 287 hips (249 patients) were included (74.9% females). The mean values
for age, body mass index, and follow-up were 16.3 ± 1.3 years, 22.3 ± 3.5, and 26.6
± 9.4 months, respectively. Further, 88.9% underwent labral repair, 81.5% femoroplasty,
and 85.4% capsular closure. Improvement for all PROs was reported (P < .001) with high patient satisfaction (8.8 ± 1.5). Achievement for the MCID was
71.7%, 83.0%, 68.1%, and 79.5% for the mHHS, NAHS, HOS-SSS, and iHOT-12, respectively.
Achievement for the PASS was 68.3% for the mHHS and 73.2% for the NAHS. The MOI for
mHHS, NAHS, and VAS was 58.3%, 77.0%, and 59.6%, respectively. Rates of revision hip
arthroscopy, cam recurrence, and heterotopic ossification were 5.8%, 1.7%, and 5.5%,
respectively. Acetabular retroversion was found to be a risk factor for revision surgery
(P = .03).
Conclusion
The results of this multi-center study demonstrated that adolescents who underwent
primary hip arthroscopy for FAIS reported significant improvement in all PROs, with
satisfactory achievement rates for the MCID, PASS, MOI, and high patient satisfaction
at a minimum 2-year follow-up.
Level of Evidence
IV, retrospective multicenter study.
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Article info
Publication history
Published online: December 07, 2022
Accepted:
November 14,
2022
Received:
May 26,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: A.J.K. reports grants from Aesculap/B. Braun, DJO LLC, personal fees from Arthrex, and Responsive Arthroscopy LLC, outside the submitted work. He also reports board membership/committee member with American Journal of Sports Medicine, International Cartilage Repair Society, International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine. Full ICMJE author disclosure forms are available for this article online, as supplementary material. B.G.D. is a board member of the American Hip Institute Research Foundation, AANA Learning Center Committee, the Journal of Hip Preservation Surgery, and the Journal of Arthroscopy; he has ownership interests in the American Hip Institute, Hinsdale Orthopedic Institute, Hinsdale Orthopedic Imaging, SCD#3, North Shore Surgical Suites, and Munster Specialty Surgical Center. He also reports grants from the American Orthopedic Foundation (during the conduct of the study), Medacta, Stryker, Breg, Medwest Associates, ATI Physical Therapy, and Ossur, during the conduct of the study; personal fees from Amplitude, DJO Global, Stryker, Orthomerica, and St. Alexius Medical Center. He also have received patents 8708941, Adjustable multi-component hip orthosis with royalties paid to Orthomerica and DJO Global; 8920497, Method and instrumentation for acetabular labrum reconstruction with royalties paid to Arthrex; and 9737292, Knotless suture anchors and methods of tissue repair with royalties paid to Arthrex. B.A.L. reports personal fees from Arthrex and Smith & Nephew and stock or stock options from COVR Medical, outside the submitted work. He also reports editorial board membership of Journal of Knee Surgery, Knee Surgery, Sports Traumatology, Arthroscopy, and Orthopedics Today. D.R.M. reports nonfinancial support from Arthrex, Stryker, Ossur, and Smith & Nephew, outside the submitted work. He is also an editorial board member of the Journal of Arthroscopy. K.R.O. reports personal fees from Arthrex, Smith & Nephew, Endo Pharmaceuticals, and Pinnacle, outside the submitted work.
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© 2022 by the Arthroscopy Association of North America
