TP3.5 Minimum 10-Year Clinical and Radiographic Outcomes after Hip Arthroscopy for Femoroacetabular Impingement (FAI) with Labral Repair and Femoral Osteachrodroplasty: A Retrospective Cohort Study

Abstract

Abstract Purpose The purpose of this study was to evaluate the minimum 10-year clinical and radiographic outcomes of primary hip arthroscopy for symptomatic FAI treated with labral repair and femoral osteochondroplasty. Methods Consecutive patients undergoing primary unilateral hip arthroscopy between 2011 and 2015 were reviewed. Patients with labral resection/reconstruction, cartilage procedures, prior ipsilateral surgery, bilateral procedures, acetabular dysplasia, or advanced preoperative osteoarthritis were excluded. Outcomes included modified Harris Hip Score (mHHS), 12-item International Hip Outcome Tool (iHOT-12), visual analog scale (VAS) pain score, radiographic osteoarthritis progression according to Tönnis and Kellgren-Lawrence classifications, reoperations, and survivorship. Results Of 393 eligible patients, 120 met inclusion criteria. At minimum 10-year follow-up, 104 patients were available for clinical and radiographic evaluation at a mean follow-up of 11.3 ± 1.1 years, yielding an overall follow-up rate of 86.7%. Mean mHHS improved from 65.8 ± 10.1 to 92.4 ± 6.1, mean iHOT-12 from 48.8 ± 15.1 to 84.7 ± 6.9, and mean VAS pain score from 6.1 ± 2.9 to 2.0 ± 1.8 (all P < .01). Five patients (4.2%) underwent conversion to total hip arthroplasty for severe osteoarthritis and 1 (0.8%) underwent revision arthroscopy, corresponding to an overall failure rate of 5.0%. Kaplan-Meier failure-free survivorship was 95.5% at 10 years. Radiographic osteoarthritis progression was observed in 46.1% of hips, although none of these patients presented a Tönnis grade 3 or Kellgren-Lawrence grade 4 osteoarthritis. Conclusion In appropriately selected patients, hip arthroscopy for FAI provided durable clinical improvement, high survivorship, and limited progression to severe osteoarthritis at minimum 10-year follow-up.