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.