EP3.47 Age and Intraoperative Cartilage Status as Determinants of Mid-Term Functional Outcomes After Hip Arthroscopy

Abstract

Abstract Introduction Femoroacetabular impingement syndrome (FAIS) is one of the leading causes of hip pain in young adults, particularly in athletes. Femoral and/or acetabular morphological abnormalities lead to mechanical conflict, resulting in cartilage and acetabular labral damage. Hip arthroscopy is the surgical treatment of choice in appropriately selected cases, although outcomes may be influenced by several prognostic factors. The aim of this study was to evaluate mid-term functional outcomes after hip arthroscopy for FAIS and to identify prognostic factors associated with postoperative outcomes, with particular attention to patient age and intraoperative cartilage status, at a minimum follow-up of 5 years. Materials and Method A retrospective analysis was conducted on patients who underwent hip arthroscopy for FAIS performed by a single surgeon between 2015 and 2020. Patient-reported outcome measures (PROMs), including the Hip Outcome Score (HOS), Hip Outcome Score Sports Subscale (HOS-SS), Harris Hip Score (HHS), and WOMAC, were collected preoperatively and at a minimum follow-up of 5 years. Univariate linear regression analyses were performed and, when indicated, multivariate analyses were also carried out. Results Between 2015 and 2020, a total of 161 hip arthroscopies were performed. Overall, 87 patients were included in the study, accounting for 91 hips. All PROMs showed significant improvement from preoperative assessment to follow-up. Increasing age was significantly associated with worse postoperative HOS, HOS-SS, and HHS values, as well as with higher WOMAC scores. No significant associations were found between postoperative outcomes and sex, BMI, type of acetabular labral damage, or femoral and acetabular cartilage status. Multivariate analysis identified age as the only independent predictor of postoperative HHS. Discussion Although chondral damage is often considered a negative prognostic factor in the literature, in our series age showed a greater prognostic impact than intraoperative cartilage grading. This finding suggests that age may more broadly reflect the biological and degenerative status of the joint, thereby influencing mid-term functional outcomes. Conclusions Patient age was independently associated with mid-term functional outcomes after hip arthroscopy. Therefore, although outcomes are multifactorial, age should be considered a relevant factor in surgical indication and preoperative counseling.