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Do the outcomes of hip arthroscopy for femoroacetabular impingement change over time? - 12/06/22

Doi : 10.1016/j.otsr.2021.103157 
Patrick G. Robinson a, , Helen Lu b, Tom Williamson b, Julian F. Maempel c, Iain Murray a, Deborah J. MacDonald a, David F. Hamilton a, Paul Gaston a
a Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK 
b Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK 
c Department of Trauma & Orthopaedics, Mater Dei Hospital, Msida, Malta 

Corresponding author.

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Abstract

Background

The purpose of this study was to search for changes in functional outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) between short and medium-term follow-up. Secondary aims included reporting rates of revision surgery and total hip arthroplasty (THA) at medium-term follow-up.

Hypothesis

We hypothesised that patients’ functional outcomes would improve between short and medium-term follow-up.

Patients and Methods

Consecutive patients undergoing hip arthroscopy with a diagnosis of femoroacetabular impingement with labral tears between February 2013 and June 2015 were included. Twelve item international hip outcome tool (iHOT-12) and EuroQol 5D-5L (EQ-5D) scores were collected preoperatively, at short-term and medium-term follow-up. Short-term scores were recorded at a minimum of one year postoperatively and medium-term scores at a minimum of five years postoperatively. Survivorship was assessed with Kaplan-Meier analysis.

Results

Short-term outcome data (at median follow-up 1.6 year, Interquartile range [IQR] 1–2.5) was available for 70 of 87 patients (80.5%) and medium-term outcome data (at median follow-up of 6.5 years, IQR 6–7.1) was available for 68 patients (78.2%). Median age at the time of surgery was 31 years (IQR 25–37). The median iHOT-12 scores at short and medium-term follow-up were 72 (IQR 48.75–91.25) and 85.8 (IQR 66.7–96.7) respectively (p<0.001). Medium-term survivorship was 91.2%. Survivorship following labral repair was 94.2%, and 81.3% following labral debridement (p=0.09).

Discussion

Patients undergoing hip arthroscopy for FAI reported continued improvement in iHOT-12 scores between short and medium-term follow-up. Medium-term survivorship following FAI surgery may be greater when the labrum is repaired, although comparisons are limited by their differing indications. Conversion to THA was low with just 4 patients (4.6%) undergoing or being listed for THA at final follow-up.

Level of Evidence

IV, Case series.

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Keywords : Femoroacetabular, Impingement, Arthroscopy, Hip, Survivorship


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Vol 108 - N° 4

Articolo 103157- giugno 2022 Ritorno al numero
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