Poster 149. Patients with Atypical Hip Pain due to Femoroacetabular Impingement Have Equivalent Outcomes 10 Years after Primary Hip Arthroscopy

Abstract

Objective: To evaluate patient-reported outcomes (PROs) and reoperation rates in patients undergoing primary hip arthroscopy for FAI over a minimum 10-year follow-up stratified by hip pain location. Methods: A retrospective cohort study was conducted on patients undergoing primary hip arthroscopy for FAIS between 2010 and 2013. All included patients had radiographic and clinical evidence of FAIS as well as a minimum of 10-years of follow-up. Patients were stratified into typical (anterior groin) and atypical (lateral or posterior) pain cohorts based on preoperative pain location. Patients were then propensity matched 3:1 by age, sex, BMI, and Tönnis grade to minimize confounding. Primary outcomes included 10-year modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) as well as change in score from baseline to final follow-up. Secondary outcomes were rates of revision surgery and conversion to total hip arthroplasty (THA). Results: Following matching, 108 patients were included (81 typical pain, 27 atypical pain). Both groups demonstrated significant improvement in PROs from baseline to 10-year follow-up with no significant differences between cohorts (P > 0.05). Mean mHHS improvement was 39.85 ± 14.75 in the typical group versus 37.45 ± 14.86 in the atypical group (P = 0.322), while NAHS improvement was 40.27 ± 15.77 and 38.2 ± 16.97, respectively (P = 0.799). Revision surgery occurred in 6.2% of typical and 3.7% of atypical patients while conversion to THA occurred in 6.2% and 3.7%, respectively (P = 1.0 for both analyses). Rates of achieving the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) for both PROs were also similar across cohorts. Conclusions: Hip arthroscopy provides comparable improvements in PROs and rates of MCID achievement, revision hip arthroscopy, and THA at 10-year follow-up. Long-term success can be expected for appropriately indicated patients with clinical and radiographic evidence of FAIS, irrespective of pain pattern.