Rate of Revision Hip Arthroscopy for Pediatric Femoroacetabular Impingement: A Systematic Review

Abstract

Femoroacetabular impingement (FAI) can cause pain, dysfunction, and early arthritic progression in young patients. The purpose of this study was to systematically review the evidence in literature to determine patient-reported outcomes and failure rates as defined by the need for revision surgery, following hip arthroscopy for pediatric patients with FAI. The literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies evaluating the outcomes following primary hip arthroscopy for pediatric patients with FAI were included. Clinical outcomes evaluated included revisions, complications, functional outcome scores (modified Hip Harris Score [mHHS], Non-Arthritis Hip Score, and Visual Analogue Score), and return to play. Statistical analysis was performed using GraphPad Prism version 7. This study is a level IV systematic review. Overall, 20 clinical studies with 1,136 patients (1,223 hips) were included in this review, with an average age of 16.3 years. Overall, 8.6% patients experienced revision surgery. The mHHS was the most widely used metric, present in 17 of the 20 studies. The mHHS was reported as excellent (> 90) in six of these studies and good (80–89) in 11. The weighted mean of the post-operative mHHS found across reporting studies was 84.3, from a baseline score of 58.1. The overall return to play rate was 91%. This study reports excellent post-hip arthroscopy clinical outcomes for FAI and labral tears in the pediatric population. However, revision rates for this surgical procedure are higher than previously documented.