Abstract
Osteoarthritis (OA) of the hip is a common cause of hip pain. The arthroscopic management of patients with femoro-acetabular impingement (FAI) has been reported to yield good outcomes. The purpose of this study was to report on outcome following the arthroscopic treatment of patients with FAI in the presence of mild to moderate OA. Seventy-five patients undergoing arthroscopic surgery for FAI, all with preoperative radiological signs of mild to moderate OA were prospectively included in this study. A 2-year follow-up, using web-based patient-reported outcome measures, including the International Hip Outcome Tool (iHOT-12), Copenhagen Hip and Groin Outcome (HAGOS), EQ-5D, Hip Sports Activity Scale (HSAS) for physical activity level and a visual analogue scale (VAS) for overall hip function, was performed, complemented by a radiographic evaluation. At follow-up (mean 26 months, SD 5), five patients (7%) had undergone total hip arthroplasty, leaving 70 patients for the analysis. Preoperative scores compared with those obtained at the 2-year follow-up revealed significant improvements (P < 0.0001) for all measured outcomes; the iHOT-12 (42 versus 65), VAS for global hip function (48 versus 68), HSAS (2.5 versus 3), EQ5D index (0.62 versus 0.76), EQ VAS (69 versus 75) and different HAGOS subscales (54 versus 72, 47 versus 67, 56 versus 75, 40 versus 61, 33 versus 56, 31 versus 55). At follow-up, 56 (82%) patients reported that they was satisfied with the outcome of surgery. Arthroscopic treatment for patients with FAI in the presence of mild to moderate OA resulted in statistically significant and clinically relevant improvements in outcome measures related to pain, symptoms, function, physical activity level and quality of life in the majority of patients.
Highlights
Femoro-acetabular impingement (FAI) has been regarded as a causal factor in the development of hip osteoarthritis (OA) [1,2,3,4]
The purpose of this study was to evaluate the arthroscopic treatment of FAI in the presence of OA in terms of pain, symptoms, function, physical activity level and quality of life using outcome measures validated for young, active patients with hip symptoms
First followup was first made at an average of 12.8 months (SD 1.7), including radiographs, where all 71 available patients responded
Summary
Femoro-acetabular impingement (FAI) has been regarded as a causal factor in the development of hip osteoarthritis (OA) [1,2,3,4]. FAI has been reported to be an isolated cause of pain and reduced range of motion (ROM) in the hip and groin area [5, 6]. High-level physical activity in adolescents has, been regarded as a causal factor in the development of cam deformity, leading to FAI [7, 8]. A few studies have evaluated patients with FAI and OA These studies report generally positive results in terms of patient-reported outcome measures (PROMs) [15,16,17,18,19].
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