High Survival Rate and Satisfaction at More Than 11-Year Follow-Up After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Impact of Preoperative Functional Scores, Osteoarthritis, and Chondrolabral Junction Damage on Failure.

Abstract

Purpose: To investigate the survival and durability of clinical improvements after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) at a minimum of 10-year follow-up.

Methods: Data from patients who underwent HA for FAIS between March 2003 and May 2012 were collected and retrospectively reviewed. Patients who underwent evaluation at a minimum 10-year follow-up, assessed according to the Hip Outcome Score (HOS)-Activities of Daily Living, HOS-Sport-Specific Subscale, and Non-arthritic Hip Score, were included. Satisfaction ratings were collected. Statistical analysis assessed within-group differences and survival.

Results: This study included 95 patients with an average follow-up period of 11.8 years. The mean age was 39.5 ± 11.0 years. The overall total hip replacement (THR) conversion rate was 24.2%, with a mean time of 3.4 ± 3.2 years. Hip joint preservation surgery revision was required in 3.2% of patients at a mean of 3.2 ± 3 years. The rate of survivorship at 10 years was 72.6%. The minimal clinically important difference was achieved by 28 patients for the HOS-Activities of Daily Living (73.6%), 28 patients (75.6%) for the HOS-Sport-Specific Subscale, and 33 patients (84.6%) for the Non-arthritic Hip Score. The patient acceptable symptom state was achieved by 42 patients (61.7%), 43 patients (65.1%), and 44 patients (64.7%), respectively. Comparative analysis between patients whose hip was preserved and those who underwent hip joint preservation surgery revision or THR highlighted that Tönnis grade 2 or greater, chondrolabral junction damage, and lower preoperative scores were associated with failure.

Conclusions: HA for FAIS showed durable results, with an acceptable THR conversion rate and sustained clinical benefits. Of the patients whose hip was preserved, 91.3% were satisfied. Tönnis grade 2 or greater, magnetic resonance arthrography signs of chondrolabral junction damage, and lower preoperative functional status are strongly associated with failure.

Level of evidence: Level IV, therapeutic case series.