EP3.24 Arthroscopic Outcomes of Acetabular Rim Fracture Excision: A Multicenter Controlled Study

Abstract

Abstract Purpose To report arthroscopic outcomes of patients with femoroacetabular impingement syndrome (FAIS) with acetabular rim fracture undergoing excision compared with a matched control group. Methods A multicenter retrospective review of prospectively collected data was performed on adult patients that underwent primary unilateral hip arthroscopy for femoroacetabular impingement syndrome (FAIS) without dysplasia (LCEA<25 degrees) and no significant arthritis (Tonnis 0 and 1). The study group had acetabular rim fractures treated with arthroscopic fragment excision. A control group was obtained with 1:1 matching using a priority-weighted, 11-variable matching system including age, gender, body mass index, lateral center edge angle (LCEA), Alpha angle, Tönnis grade, Beck chondral grade, presence of labral bruising, complexity of labral tearing (none, mild, moderate, or severe), labral treatment (repair vs reconstruction), and presence or absence of femoroplasty and acetabuloplasty. Preoperative and minimum 2-year postoperative International Hip Outcome Tool short form (iHOT-12) were recorded. Paired t-tests were utilized to examine intragroup differences from baseline to follow-up. Unpaired t-tests were utilized to examine intergroup differences between the rim fracture and control cohorts. The proportion of patients who met the Patient Acceptable Symptom State (PASS), Substantial Clinical Benefit (SCB), and Minimal Clinically Important Difference (MCID) was analyzed using Chi-square tests to compare these proportions across cohorts. Results The average preoperative and 2-year minimum postoperative iHOT-12 scores for the study group were 41.6 ± 22.2 and 75.3 ± 26.7, respectively. The average preoperative and 2-year minimum postoperative iHOT-12 scores for the control cohort were 38.3 ± 17.8 and 76.7 ± 24.1, respectively. Both groups experienced statistically significant improvements in iHOT-12 from baseline to final follow-up (p < 0.001) and there was no statistically significant difference between cohorts in iHOT-12 scores at baseline or final follow-up (p=0.529). The proportion of the study cohort that met the MCID, SCB, and PASS were 80%, 55%, and 75%, respectively, while the proportion of the control cohort that met the MCID, SCB, and PASS were 85%, 60%, and 75%, respectively. There was no significant difference between cohorts in the proportion of patients who met MCID, SCB, and PASS (χ2(1, N = 40) = 0.17, p = .68; χ2(1, N = 40) = 0.10, p = .75; and χ2(1, N = 40) = 0.00, p = 1.00), respectively. Conclusion Arthroscopic excision of acetabular rim fractures in nonarthritic non-dysplastic patients with FAIS is a viable treatment option with successful 2-year minimum outcomes similar to strictly matched patients without rim fractures.