Hip Arthroscopy for Femoroacetabular Impingement in Adolescents: 10-Year Patient-Reported Outcomes

Abstract

Background: Previous studies have demonstrated hip arthroscopy to be an effective treatment for femoroacetabular impingement (FAI) in individuals 18 years of age and older. Long-term outcome data in the adolescent population, however, are limited. Purpose: To report 10-year outcomes after hip arthroscopy in adolescents with symptomatic FAI. Study Design: Case series; Level of evidence, 4. Methods: Prospectively collected data were analyzed on adolescent patients younger than 18 years of age who had hip arthroscopy between March 2005 and 2009 with a minimum 10-year follow-up. Patients were included if they were diagnosed with symptomatic FAI and an associated labral tear that was treated with repair. Patients were excluded if they had previous hip procedures, acetabular dysplasia (lateral center-edge angle, <20°), avascular necrosis, previous hip fracture or dislocation, or Legg-Calve-Perthes disease, or refused to participate. The primary patient-reported outcome measure was the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale. In addition, the HOS—Sport, modified Harris Hip Score (mHHS), 12-Item Short Form Health Survey (SF-12), and patient satisfaction were collected. Failure was defined as patients having to undergo revision arthroscopy. Results: There were 60 patients (70 hips) who met inclusion criteria and had a 10-year follow-up. The mean age of the cohort was 16 ± 1.2 years, with 21 male and 49 female hips. Seven hips (10%) required revision hip arthroscopy. All revisions occurred in female patients and were associated with global laxity as well as longer duration of symptoms before time of surgery. At a mean follow-up of 12 years (range, 10-14 years), patients who did not undergo revision surgery had significant improvements from preoperatively to postoperatively in HOS-ADL (from 64 to 92; P < .01), HOS–Sport (from 40 to 86; P < .01), mHHS (from 56 to 88; P < .01), and SF-12 Physical Component Summary (from 41 to 54; P < .01). The median patient satisfaction was 10 out of 10 (very satisfied). Conclusion: Hip arthroscopy for FAI with labral repair resulted in excellent patient-reported outcomes and satisfaction at a minimum of 10 years of follow-up. There was a 10% rate of revision surgery, which was associated with global laxity and longer duration of symptoms before surgery, which should be considered in patient selection.

Rehabilitation and Return to Sport After Arthroscopic Treatment of Femoroacetabular Impingement: A Review of the Recent Literature and Discussion of Advanced Rehabilitation Techniques for Athletes

“…Collection of PROs may be performed preoperatively and at regular intervals in follow-up. 20 Some commonly used PROs include the modified Harris hip score (mHHS), hip outcomes score (HOS; activities of daily living and sports-specific subscales), nonarthritic hip score (NAHS), and lower extremity functional scale (LEFS); several other PROs are used and could also be considered. Tracking the scores and graphically displaying the results for the patient at selected intervals could be beneficial both in terms of patient education, as well as readiness for return to sport.…”

Arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) in adolescents—5-year follow-up

“…However, there is currently limited medium- and long-term data reporting on the results of arthroscopic treatment for FAIS in adolescents [ 17 , 18 ] and no previous study has selectively reported the outcome in adolescents using the Copenhagen Hip and Groin Outcome Score (HAGOS).…”

Nonoperative Management of Femoroacetabular Impingement in Adolescents: Clinical Outcomes at a Mean of 5 Years: A Prospective Study

“…Again, this study did not report nonoperative outcomes. Furthermore, Menge et al 12 reported significant improvements in multiple PROs, including the mHHS (from 56 to 88) at 10 years after hip arthroscopy in a cohort of adolescent patients. This study did not include a nonoperative comparison group but did offer activity modification and physical therapy before surgery.…”