FAI may cause pain or functional impairment for an individual, as well as potentially resulting in arthritis and degeneration of the hip joint. Results from recent randomised control trials demonstrate the superiority of surgery over physiotherapy in patients with FAI. However, there is paucity of evidence regarding which factors influence outcomes for FAI surgery, most notably on patient reported outcomes measures (PROMs).

Our study looks to explore factors influencing the outcomes for patients undergoing surgery for FAI utilising data from the Non-Arthroplasty Hip Registry.

This study is a retrospective analysis of data collected prospectively via the NAHR database. Patients meeting the inclusion criteria, who underwent surgery between January 2011 and September 2019 were identified and included in the study. Follow-up data was captured in September 2020 to allow a minimum of 12 months follow-up.

Patients consenting to data collection received questionnaires to determine EQ-5D Index and iHOT-12 scores preoperatively and at 6 months, 1, 2- and 5-year follow-up.

Changes in outcome scores were analysed for all patients and sub-analysis was performed looking at the influence of; FAI morphological subtype, age, and sex, on outcome scores.

Our cohort included 4,963 patients who underwent arthroscopic treatment for FAI. There was significant improvement from pre-operative PROMs when compared with those at 6 and 12 months.

Pre-operatively, and at 12-month follow-up, iHOT-12 scores were significantly better for the cam / mixed groups compared to the pincer group (p<0.01).

In multivariable regression analysis, pincer pathology and a high-grade chondral lesion were associated significantly poorer iHOT-12 improvement at 6 and 12 months (p<0.05)

Age (<40 vs >40) demonstrated no statistical significance when considering 12 months outcome scores.

This study demonstrates that hip arthroscopy is an effective treatment for patients with symptomatic FAI and shows statistically significant improvements at 12 months.

The findings of this study are relevant to orthopaedic surgeons who manage young adults with hip pathology. This will help them to; predict which patients may benefit from operative intervention, and better inform patients, when undertaking shared decision making.

Pelvic re-orientation osteotomy is a well-recognised treatment of young adults with developmental dysplasia of the hip (DDH).

The most commonly used technique is the periacetabular osteotomy (PAO), however, some surgeons favour a triple osteotomy. These techniques can also be utilised for acetabular retroversion leading to FAI.

Despite the published literature on these techniques, the authors note a scarcity of evidence looking at patient reported outcome measures (PROMs) for these procedures.

This was a retrospective analysis of prospectively collected data utilising the UK NAHR. All patients who underwent pelvic osteotomy from January 2012 to November 2019 were identified from the NAHR database. Patients who consented to data collection received EQ-5D index and iHOT-12 questionnaires, with scores being collected pre-operatively and at 6, 12 and 24 months post-operatively.

Nine hundred and eleven (911) patients were identified with twenty-seven (27) undergoing a triple osteotomy, the remaining patients underwent PAO. Mean age was 30.6 (15–56) years and 90% of patients were female. Seventy-nine (79) (8.7%) of patients had the procedure for acetabular retroversion leading to FAI

Statistical analysis, of all patients, showed significant improvement (p<0.001) for; iHOT-12 scores (+28 at 6-months, +33.8 at 12-months and +29.9 at 24-months)

Similarly there was significant improvement (p<0.001) in EQ-5D index (+0.172 at 6-months, +0.187 at 12-months and +0.166 at 24-months)

Pre-operatively, and at each follow-up time-period, raw scores were significantly better in the DDH group compared to the FAI group (p<0.05); however, the improvement in scores was similar for both groups.

For both scoring measures, univariable and multivariable linear regression showed poorer pre-operative scores to be strongly significant predictors of greater post-operative improvement at 6 and 12 months (p<0.0001).