10-12 Year Long Term Outcomes and Survivorship of Hip Arthroscopy for Symptomatic FAI

Abstract

Hip arthroscopy is being used with increasing frequency to address labral pathology and associated femoral-acetabular impingement (FAI) syndrome, yet little is known about the degree of functional recovery and long term outcomes following this procedure. The purpose of this study was to prospectively collect long term, 10-12 year follow up hip outcome scores and survivorship data from a previously IRB approved cohort of patients who underwent hip arthroscopy for Symptomatic FAI. All patients underwent a preoperative and postoperative strength test evaluation by a single physical therapist following arthroscopic hip surgery done by a single surgeon for labral pathology and associated FAI. Inclusion criteria for this follow up study included patients that attempted failed conservative treatment with history and exam findings consistent with FAI, an MRI confirming a labral tear and an X-ray and/or CT scan confirming femoroacetabular impingement. This resulted in a final group of 26 patients (16 female, 10 male) with ages ranging from 24 to 61 years (mean ± SD, 37.0 ± 11.9 years). This cohort of patients was contacted 10-12 years following their initial surgery date to obtain their long term Total Hip Outcome Score (HOS), HOS Activity of Daily Living, HOS Sports Scale (Total HOS, HOS ADL, HOS Sport) and modified Harris Hip Scores (mHHS). Completed questionnaires were obtained in April 2019 from 10 patients ranging from 9 to 12 years (mean 10.6 years) post operatively from their arthroscopic hip surgery. The mean mHHS score was 88.55 (70.4 to 100.1). The mean HOS ADL was 90.1 and mean HOS Sport was 78.5, with a mean Total HOS Score of 87 ± 10.9 (mean ± SD). Patients rated their current level of function in daily living to be 91% and their current level of function during sports related activity to be 82% on a 0% to 100% scale, with 0 being the inability to perform. It was also shown that Hip Outcome Scores improved significantly from pre-operative to 2 year post-operative assessment (67±15 to 82±13, P = 0.036, n=13). Hip Outcome Scores further improved significantly from 2 years post op to the 10 year post op follow up (82 ± 13 to 86 ± 10.8, P < 0.05, n=7). This study demonstrated that hip arthroscopy for labral pathology and FAI leads to both short and long term return improved function using patient reported outcomes, as well as showed a successful return to daily activity and sport. There are only a few reports showing any long term FAI outcome and only one study showing outcomes post arthroscopic management of labral repair and femoral osteoplasty, but that includes labral debridement, making this the first of its kind to demonstrating 10 year outcomes of this procedure.