PAPER 179: 2-YEAR OUTCOMES OF HIP ARTHROSCOPY

Abstract

Purpose: This purpose of this study was to report 2 year outcomes following hip arthroscopy for the treatment of femoroacetabular impingement and chondrolabral dysfunction and determine factors associated with outcomes.

Method: Between 3/2005 and 10/2005, 122 patients underwent hip arthroscopy by a single surgeon. Patients were included if they underwent arthroscopic treatment for FAI and chondrolabral dysfunction. All patients were prospectively enrolled in an IRB approved follow-up study. Ten patients refused to participate following enrollment.

Results: At arthroscopy, for treatment of impingement, 23 patients underwent only osteoplasty for CAM impingement, 3 patients underwent only rim reduction for pincer impingement and 86 patients underwent osteoplasty and rim reduction for mixed type impingement. Ten patients underwent total hip arthroplasty at an average of 16 months (range: 8–26) after arthroscopy. Average follow-up was obtained on 90%(92/102) at 2.3 years (range: 2.0–2.9). The modified Harris Hip score(MHHS) improved from 57 to 84. HOS ADL improved from 69 to 88. HOS Sport improved from 41 to 69. NAHS improved from 64 to 82. All scores significantly improved (p< 0.05). The average patient satisfaction was 8.4 (range: 1–10). All patients returned to work (15% returned within 1 week, 53% returned in 1–5 weeks, 18% returned in 6–8 weeks, 13% returned in 2 to 6 months). Ten patients underwent THA at an average of 16 months. These patients were significantly older at arthroscopy (58 vs. 39;p=0.0001), had significantly less joint space at all 3 weight bearing surfaces (p=0.001), and patients with microfracture on both femoral head and acetabulum were more likely to undergo THA (p=0.001). The predictors of higher post-operative MHHS were preoperative modified Harris Hip score (p=0.018), joint space of 2mm or greater(p=0.005), and repair of labral pathology instead of debridement (p=0. 032)(r2=0.32;p=0.001). Patients with labral repair had higher MHHS compared to patients with labral debridement (87vs81). Independent predictors of patient satisfaction were postoperative MHHS(p=0.001) and joint space of 2mm or greater(p=0.040) (r2=0.67; p=0.001).

Conclusion: Hip arthroscopy for femoroacetabular impingement accompanied by the prescribed rehabilitation led to return to excellent function and high patient satisfaction. Factors associated with higher outcomes included joint space of greater than 2mm, and labral repair for treatment of labral pathology.