Mid-term Outcomes and Survivorship of Hip Arthroscopy for the Treatment of Labral Tears and Femoro-acetabular Impingement

Abstract

Mid-term clinical outcomes for patients undergoing current hip arthroscopic treatments for labral tears and femoro-acetabular impingement (FAI) have not yet been reported. Additionally, the general population of clinicians may not be adequately informed of these pathologies, which may lead to delayed diagnoses. We conducted a retrospective review of prospectively collected data for patients that underwent hip arthroscopy between February 2008 and December 2010. Patients with previous ipsilateral hip conditions were excluded. Each patient's age at onset of hip symptoms and at surgery were documented. The modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score – Sport Specific Subscale (HOS-SSS), and visual analog scale for pain (VAS) were documented preoperatively and at a minimum of five years postoperatively. Patient satisfaction was documented at follow-up. Revision surgeries, conversions to arthroplasty, and postoperative complications were documented. We analyzed 205 hips with mean follow-up of 69.3 months. A mean of 24 months between onset of hip symptoms and surgery was observed. There were significant improvements in all patient-reported outcomes (PROs) from preoperatively to latest follow-up: mHHS (64.8 to 82.8), NAHS (62.2 to 85), HOS-SSS (47.2 to 75), and VAS (5.8 to 2.1). Mean satisfaction at follow-up was 8.0. Fourteen patients underwent revision arthroscopy during the follow-up period. Survivorship at latest follow-up was 89.3%. There was a 5.4 rate of major complications; the most common was numbness, which occurred after 2.4% of surgeries and resolved in 80% of cases. Hip arthroscopy for the treatment of labral tears and FAI is a safe procedure that demonstrates good mid-term results with high patient satisfaction and 89.3% survivorship. These pathologies may have delayed diagnoses, which is supported by the two-year differential between onset of hip symptoms and surgical treatment.