Paper 17: Does Higher Quality CAM Resection Correlate with Better Patient-Reported Outcomes?

Abstract

Objectives: The relationships between CAM resection quality and patient-reported outcomes (PROs) are unknown in the literature. This study aimed to investigate the correlation of CAM resection quality with patient’s self-reported International Hip Outcome Tool (iHOT) scores collected annually post-surgery. Methods: A retrospective analysis was conducted including patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) between 2012 and 2019. Inclusion criteria were pre-operative radiographic signs of CAM-type impingement (alpha angle > 55 °) and post-operative plain radiographs. Exclusion criteria were radiographic signs of a pincer or mixed impingement, history of femoral neck or proximal femur fracture, and treatment of concomitant hip pathologies. The following data were collected: demographic information, radiographic findings, and iHOT scores. CAM resection quality data were categorized based on findings from three plain radiographs (anteroposterior (AP) pelvis, frog leg lateral, and 45° Dunn views). High quality resections were defined as those post-operative alpha angle <55°. Results: This study included 148 participants who underwent CAM resection. From Frog leg views, 88% of patients had high-quality resections and presented superior post-operative iHOT scores compared to the 12% of patients with poor resection quality during the 1-year to 5-year follow-up period. Likewise, from Dunn views 82% of patients with a high-quality CAM resection displayed a similar trend in post-operative iHOT scores compared to 18% of patients with poor resection quality on Dunn views. However, this positive association between resection quality and post-operative iHOT scores was not evident in AP imaging. With AP views, 82% of patients with high-quality resections did not show a significant difference in iHOT scores compared to 18% of patients with poor resection quality. Conclusions: This study found that high quality CAM resection from arthroscopic surgery correlated with better iHOTs up to 5-years post-surgery from the Dunn and frog leg radiographic imaging views.