Femoroacetabular impingement (FAI) is a common cause of hip pain and dysfunction. The purpose of this study was to report outcome 2 years after the arthroscopic treatment of FAI using validated outcome measurements. Two hundred and eighty-nine patients (males = 190, females = 99) with a mean age of 37 years underwent arthroscopic surgery for FAI. Patients were included consecutively in a hip arthroscopy registry. The cohort was evaluated using online web-based validated health-related patient-reported outcomes measurements, including the iHOT-12, HAGOS, EQ-5D, HSAS for physical activity level, VAS for overall hip function and overall satisfaction. The mean follow-up time was 25.4 months. Pre-operative scores compared with those obtained at follow-up revealed statistically and clinically significant improvements (P < 0.05) for all measured outcomes; iHOT-12 (43 vs 66), VAS for global hip function (50 vs 71), HSAS (2.9 vs 3.6), EQ-5D index (0.58 vs 0.75), EQ-VAS (67 vs 75) and HAGOS different subscales (56 vs 76, 51 vs 69, 60 vs 78, 40 vs 65, 29 vs 57, 33 vs 58). At the 2-year follow-up, 236 patients (82%) reported they were satisfied with the outcome of surgery. We conclude that arthroscopic treatment for FAI resulted in statistically and clinically significant improvements in outcome parameters.
Purpose The purpose of the present study was to evaluate the outcome of arthroscopic treatment for femoroacetabular impingement (FAI) syndrome 5 years post-surgery using patient-reported outcome scores (PROMs) validated for a young and active population with hip complaints. Methods Patients were prospectively included in the study. A total of 184 patients [males = 110 (59.8%), females = 74 (40.2%)], with mean age 38.0, underwent arthroscopic treatment for FAI syndrome and were analysed. Preoperatively and at the 5-year follow-up, patients completed a set of self-administered web-based PROMs consisting of the International Hip Outcome Tool (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), the Hip Sports Activity Scale (HSAS), the EuroQoL-5 Dimension Questionnaire (EQ-5D), the EQ-Visual Analogue Scale (VAS) and the VAS for overall hip function and overall satisfaction. The Wilcoxon signed rank test was used to compare preoperative PROM values with those obtained at the 5-year follow-up. Results A comparison of preoperative PROM scores and those obtained at the 5-year follow-up revealed statistically significant improvements for all outcome scores (p < 0.05), except for the HSAS score, which were unchanged; iHOT-12 (42.9
Background: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and disability in athletes. Arthroscopic treatment for FAIS is well-established; however, the long-term results in elite athletes are limited. Purpose: To evaluate outcomes 5 years after arthroscopic treatment for FAIS in elite athletes. Study Design: Case series; Level of evidence, 4. Methods: Elite athletes undergoing arthroscopic treatment for FAIS with a minimum 5-year follow-up were included. They were prospectively followed up with patient-reported outcome measures. An elite athlete was defined as having a Hip Sports Activity Scale (HSAS) level of 7 or 8 before the onset of symptoms. Preoperatively and 5 years after surgery, all athletes completed a web-based questionnaire, including the Copenhagen Hip and Groin Outcome Score (comprising 6 subscales), the EQ-5D and EQ-VAS (European Quality of Life–5 Dimensions Questionnaire and European Quality of Life–Visual Analog Scale), iHOT-12 (International Hip Outcome Tool), a visual analog scale for hip function, and the HSAS. Moreover, patients reported their overall satisfaction with their hip function. Preoperative measurements were compared with the 5-year follow-up. Results: A total of 64 elite athletes (52 men, 12 women) with a mean ± SD age of 24 ± 6 years were included. On average, patients reported a statistically significant and clinically relevant improvement from preoperative patient-reported outcome measures to the 5-year follow-up ( P < .0003), Copenhagen Hip and Groin Outcome Score subscales (symptoms, 51.7 vs 71.9; pain, 61.0 vs 81.1; function of daily living, 67.1 vs 83.6; function in sports and recreation, 40.0 vs 71.5; participation in physical activity, 25.0 vs 67.4; hip and groin–related quality of life, 34.4 vs 68.0), EQ-5D (0.60 vs 0.83), EQ-VAS (66.1 vs 76.7), and iHOT-12 (40.0 vs 68.8). At the 5-year follow-up, 90.5% reported satisfaction with their overall hip function. In total, 54% still participated in competitive sports (HSAS, 5-8) at follow-up, while 77% had decreased their level. Older patients and patients with longer duration of symptoms reported a significantly lower level of sports activity (HSAS, 0-4; P < .009). Conclusion: Arthroscopic treatment for FAIS in elite athletes results in a statistically significant and clinically relevant improvement regarding symptoms, hip function, quality of life, and pain 5 years after surgery. Approximately half of the cohort was still in competitive sports at follow-up, yet 77% had decreased their level of sports. Nine of 10 patients were satisfied with their surgery.
Purpose To translate and culturally adapt the Hip Sports Activity Scale (HSAS) to Swedish and validate the Swedish version in patients with femoroacetabular impingement (FAI) syndrome. Materials and Method The original German version was translated to Swedish. To determine reliability, validity, and floor and ceiling effects, a questionnaire set consisting of the Swedish version of the HSAS, the Copenhagen Hip and Groin Outcome Score (HAGOS), the short version of the international hip outcome tool, and the Tegner Activity Scale was completed pre‐operatively by 30 patients planned for arthroscopic hip surgery for FAI syndrome. To determine responsiveness, pre‐operative and one‐year follow‐up HSAS data from 30 patients treated with arthroscopic hip surgery for FAI syndrome were collected. Results For test‐retest reliability, the interclass correlation was 0.930. The HSAS correlated to the Tegner score (r = 0.794, P < 0.01), as well as to the HAGOS subscale of “physical activity” (r = 0.436, P < 0.05). Cohen's effect size and the standardized response mean were 0.25 and 0.28, respectively. Ceiling and floor effects were between 7% and 10%. Conclusion The Swedish version of the HSAS is a reliable and valid measurement to determine sports activity levels in patients with FAI syndrome.
Femoro-acetabular impingement (FAI) is a common cause of hip pain and dysfunction in the young and active population. Despite reports of good short-term outcomes following treatment for FAI, less is known about the possible preoperative predictors of treatment outcome. The purpose of this study was to identify predictors of treatment outcome, using a patient-reported outcome measurement score (PROM) validated for use in a young and active population undergoing arthroscopic surgery for FAI. Patients were prospectively enrolled and analysed using the PROM International Hip Outcome Tool (iHOT-12) preoperatively and at a 2-year follow-up. Predictors of treatment outcome chosen for analysis were age, gender, duration of symptoms until surgery, level of cartilage damage, preoperative score and FAI type. A total of 198 patients, 122 males and 76 females (M: 61.6%, F: 38.4%), with a mean age of 41 ± 12.1 years, were analysed. The preoperative iHOT-12 score correlated with the postoperative iHOT-12 score at the 2-year follow-up. For one iHOT-12 point positive difference preoperatively, an additional 0.65 points were gained postoperatively at the 2-year follow-up (P ≤ 0.001). Age, gender, symptom duration until surgery, level of cartilage damage and FAI type did not have a statistically significant correlation to the postoperative score. Preoperative hip function as measured by the iHOT-12 is a potential predictor of outcome following FAI surgery relative to other factors.
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