EP8.21 Minimum Five-Year Outcomes After Hip Arthroscopy in Patients with Global Acetabular Overcoverage and Coxa Profunda Compared to Controls

Abstract

Abstract Background Global acetabular overcoverage (GO) represents one anatomic condition that predisposes individuals to hip pathology by increasing the risk of femoroacetabular impingement (FAI). The mid-term outcomes for this patient population remain limited. Purpose (1) Evaluate minimum 5-year patient-reported outcomes (PROs) after primary hip arthroscopy for FAI and labral tears in the setting of GO. (2) Compare these results to a matched control group without GO. Study design Cohort study; Level of evidence III. Methods Prospectively collected data was analyzed for all patients who underwent primary hip arthroscopy between 2008 and 2020. Patients were included if had completed pre- and minimum 5-years post-operative questionnaires for at least one of the following patient reported outcomes (PROs): Modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Visual Analog Scale (VAS), and patient satisfaction or reaching an endpoint (revision hip arthroscopy or total hip arthroplasty (THA)). Patients with radiographic findings of GO on the AP pelvis x-ray (lateral center-edge angle (LCEA) > 40° and coxa profunda) were included in the GO cohort and were propensity matched to controls without these mentioned radiographic signs and an LCEA between 25° -40° in a 1:3 ratio based on age, sex, body mass index, acetabular Outerbridge grade, labral treatment, and capsular treatment. Demographics, intraoperative findings, procedures, clinically relevant thresholds and secondary surgeries were included in the analysis. Results A total of 204 patients were included: 51 in the GO group and 153 matched controls. The GO cohort demonstrated significant improvements across all PROs (p < 0.001). Compared to the control group, similar magnitudes of improvement and post-operative scores for all PROs were observed, reaching minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) at similar rates. The GO group had a higher frequency of revision hip arthroscopy (15.69% vs 7.84%; relative risk [RR] = 2.00) with similar rates of THA survivorship free. Conclusion Hip arthroscopy for the treatment of FAI and labral tears in patients with radiographic evidence of global acetabular overcoverage demonstrates significant improvements in PROs at a minimum 5-year follow-up. However, it carries a two-fold increased relative risk of revision hip arthroscopy compared with the control group.