Abstract
This study aims to report on a prospectively collected, multicenter database of patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAI) and concomitant cartilage damage (according to the International Cartilage Repair Society) and to assess the outcome-affecting parameters. In the study, 353 hips with up to 24 months’ follow-up were assessed by iHOT-33 scoring and achievement of the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) levels. Multiple and binary regression analyses were performed to identify factors related to (un-) favorable outcomes and to assess their clinical relevance with regard to achieving the MCID and PASS. Multiple regression yielded the parameters of male sex (p = 0.022) and lower body mass index (BMI) (p = 0.019) at 6 months, lower BMI (p = 0.022) and younger age (p = 0.022) at 12 months, and younger age at 24 months (p = 0.039) to be significantly associated with higher iHOT scoring. Male sex (p = 0.019) and lower BMI (p = 0.018) were significantly correlated with achievement of the PASS in binary regression at 6 months, whereas at 12 (p = 0.010) and at 24 (p = 0.003) only younger age was shown to be significantly correlated. None of the parameters was statistically associated with achievement of the MCID. As the parameters of younger age, male sex, and lower BMI were identified as temporarily correlated with a preferable outcome in general and with achievement of the PASS in particular, these findings help to preoperatively identify factors associated with (un-) favorable therapy results.
Highlights
Femoroacetabular impingement syndrome (FAI) is a pre-arthritic condition caused by mechanically induced chondral defects in the hip [1–4], and its treatment by means of hip arthroscopy is routine nowadays [5–9]
Cvetanovich et al reported on favorable outcomes in younger patients in terms of achieving the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) for the Hip
The assessment of outcome of hip arthroscopy for femoroacetabular impingement syndrome and its affecting parameters has recently been the focus of multiple publications [6,8,10–15,17,21]
Summary
While the overall favorable results of hip arthroscopy are largely undisputed, several parameters that affect the outcome of treatment have been identified. In the treatment of FAI, these include age, sex, and body mass index (BMI) [10]. Cvetanovich et al reported on favorable outcomes in younger patients in terms of achieving the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) for the Hip. Outcome Score (HOS) [11]. An age-dependent outcome was reported by Gupta et al. With regard to gender-related results, several authors reported more favorable outcomes for male patients. Males outperformed ageadjusted females in several scores such as the HOS, modified Harris Hip Score (mHHS), and in terms of quality of life (QoL) [14–17]. A correlation between favorable therapy results and lower BMI, and, respectively, normal BMI has been repeatedly proven using these well-established scoring systems as well as a visual analog scale (VAS) [11,18,19]
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