Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time?

Patrick G. Robinson; Helen Lu; Tom Williamson; Julian F. Maempel; Iain Murray; Deborah J. MacDonald; David F. Hamilton; Paul Gaston

doi:10.1016/j.otsr.2021.103157

Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time?

Patrick G. Robinson^*, Helen Lu, Tom Williamson, Julian F. Maempel, Iain Murray, Deborah J. MacDonald, David F. Hamilton, Paul Gaston

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

BACKGROUND: The purpose of this study was to search for changes in functional outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) between short and medium-term follow-up. Secondary aims included reporting rates of revision surgery and total hip arthroplasty (THA) at medium-term follow-up.

HYPOTHESIS: We hypothesised that patients' functional outcomes would improve between short and medium-term follow-up.

PATIENTS AND METHODS: Consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement with labral tears between February 2013 and June 2015 were included. Twelve item international hip outcome tool (iHOT-12) and EuroQol 5D-5L (EQ-5D) scores were collected preoperatively, at short-term and medium-term follow-up. Short-term scores were recorded at a minimum of one year postoperatively and medium-term scores at a minimum of five years postoperatively. Survivorship was assessed with Kaplan-Meier analysis.

RESULTS: Short-term outcome data (at median follow-up 1.6 year, Interquartile range [IQR] 1-2.5) was available for 70 of 87 patients (80.5%) and medium-term outcome data (at median follow-up of 6.5 years, IQR 6-7.1) was available for 68 patients (78.2%). Median age at the time of surgery was 31 years (IQR 25-37). The median iHOT-12 scores at short and medium-term follow-up were 72 (IQR 48.75-91.25) and 85.8 (IQR 66.7-96.7) respectively (p<0.001). Medium-term survivorship was 91.2%. Survivorship following labral repair was 94.2%, and 81.3% following labral debridement (p=0.09).

DISCUSSION: Patients undergoing hip arthroscopy for FAI reported continued improvement in iHOT-12 scores between short and medium-term follow-up. Medium-term survivorship following FAI surgery may be greater when the labrum is repaired, although comparisons are limited by their differing indications. Conversion to THA was low with just 4 patients (4.6%) undergoing or being listed for THA at final follow-up.

LEVEL OF EVIDENCE: IV, Case series.

Original language	English
Article number	103157
Number of pages	6
Journal	Orthopaedics and Traumatology: Surgery and Research
Volume	108
Issue number	4
Early online date	29 Nov 2021
DOIs	https://doi.org/10.1016/j.otsr.2021.103157
Publication status	Published - Jun 2022
Externally published	Yes

Keywords

femoroacetabular
impingement
arthroscopy
hip
survivorship
reoperation
follow-up studies
femoracetabular impingement/diagnosis
humans
hip Joint/surgery
arthroplasty, replacement, hip
treatment outcome

ASJC Scopus subject areas

Surgery
Orthopedics and Sports Medicine

Documents and Links

10.1016/j.otsr.2021.103157

Cite this

@article{78835ff6a5754031bbc2bad191d34c11,

title = "Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time?",

abstract = "BACKGROUND: The purpose of this study was to search for changes in functional outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) between short and medium-term follow-up. Secondary aims included reporting rates of revision surgery and total hip arthroplasty (THA) at medium-term follow-up.HYPOTHESIS: We hypothesised that patients' functional outcomes would improve between short and medium-term follow-up.PATIENTS AND METHODS: Consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement with labral tears between February 2013 and June 2015 were included. Twelve item international hip outcome tool (iHOT-12) and EuroQol 5D-5L (EQ-5D) scores were collected preoperatively, at short-term and medium-term follow-up. Short-term scores were recorded at a minimum of one year postoperatively and medium-term scores at a minimum of five years postoperatively. Survivorship was assessed with Kaplan-Meier analysis.RESULTS: Short-term outcome data (at median follow-up 1.6 year, Interquartile range [IQR] 1-2.5) was available for 70 of 87 patients (80.5%) and medium-term outcome data (at median follow-up of 6.5 years, IQR 6-7.1) was available for 68 patients (78.2%). Median age at the time of surgery was 31 years (IQR 25-37). The median iHOT-12 scores at short and medium-term follow-up were 72 (IQR 48.75-91.25) and 85.8 (IQR 66.7-96.7) respectively (p<0.001). Medium-term survivorship was 91.2%. Survivorship following labral repair was 94.2%, and 81.3% following labral debridement (p=0.09).DISCUSSION: Patients undergoing hip arthroscopy for FAI reported continued improvement in iHOT-12 scores between short and medium-term follow-up. Medium-term survivorship following FAI surgery may be greater when the labrum is repaired, although comparisons are limited by their differing indications. Conversion to THA was low with just 4 patients (4.6%) undergoing or being listed for THA at final follow-up.LEVEL OF EVIDENCE: IV, Case series.",

keywords = "femoroacetabular, impingement, arthroscopy, hip, survivorship, reoperation, follow-up studies, femoracetabular impingement/diagnosis, humans, hip Joint/surgery, arthroplasty, replacement, hip, treatment outcome",

author = "Robinson, {Patrick G.} and Helen Lu and Tom Williamson and Maempel, {Julian F.} and Iain Murray and MacDonald, {Deborah J.} and Hamilton, {David F.} and Paul Gaston",

year = "2022",

month = jun,

doi = "10.1016/j.otsr.2021.103157",

language = "English",

volume = "108",

journal = "Orthopaedics and Traumatology: Surgery and Research",

issn = "1877-0568",