Purpose

To (1) report clinical outcomes of arthroscopic interventions of the hip with a minimum of 5-year follow-up utilizing a cohort with femoroacetabular impingement syndrome that did not undergo hip arthroscopy, and (2) determine the influence of hip arthroscopy on the progression of osteoarthritis (OA) of the hip.

Methods and Materials

Patients who (1) presented with hip pain and were diagnosed with FAI and (2) had a minimum follow-up time of 5 years were included. Exclusion criteria were periacetabular osteotomy (PAO) performed ipsilaterally and <5 years of follow-up. A total number of 1565 patients were identified. Hip arthroscopy patients were compared to patients that presented with femoroacetabular impingement but did not undergo hip arthroscopy.

Results

A total of 201 patients were evaluated for inclusion study in the surgical group, with 129 patients (64%), comprising 45 men (35%) and 84 women (85%), eligible based on study criteria. A total of 1364 patients were evaluated for inclusion in the non-surgical group, with 1055 patients (77.3%), comprising 333 men (31.6%) and 722 women (68.4%), eligible based on study criteria. At a mean follow up of 8.4 years, 4.7% of patients of the HA group progressed to THA, compared to 4.5% of the non-operative control group. While most of the HA group showed no (21.7%) or mild signs (Tönnis 1: 65.1%) of OA at follow-up, moderate OA (Tönnis 2) was present in 8.5% of patients compared to 17.4% in the group of non-operative treatment.

Table 1. Radiographic Characteristics of all Patients as Determined by Tönnis Grade

Conclusion

At mid-term follow-up, patients treated with hip arthoroscopy had similar rates of radiographic arthritis and progression to hip arthroplasty compared to non-opeatively reated patients.