Summary

Following primary hip arthroscopy, patients younger than 21 years old reported higher PROs.

Abstract

Background

Factors such as sex and age are postulated to play a role in patient-reported outcome scores (PROs) following arthroscopy for femoroacetabular impingement syndrome (FAIS).

Purpose

To compare minimum 2-year and minimum 5-year PROs and survivorship in patients who underwent primary hip arthroscopy for FAIS and labral tear according to sex and age.

Study Design: Level IV, retrospective cohort study.

Methods

Prospectively collected data from February 2008 to September 2018 were retrospectively reviewed. Inclusion criteria were primary hip arthroscopy for FAIS and labral tear with minimum 2-year follow-up for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS). Exclusion criteria were Tönnis grade > 1, hip dysplasia, previous ipsilateral hip surgery/conditions, worker’s compensation status, or were unwilling to participate. Female and male patients were divided by age as follows: < 21 years old, 21–30 years old, 31–40 years old, 41–50 years old, 51–60 years old, and = 61 years old. Significance was set at P < 0.05.

Results

1,343 (89.5%) hips had minimum 2-year follow-up. 868 (64.6%) patients were females, and 475 (35.4%) patients were males, with a mean age of 31.9 ± 12.9 years and a mean follow-up of 58.5 ± 28.5 months. Further, 780 patients had follow-up at minimum 5-year. There were no statistically significant differences in demographics found between males and females except for alpha angle. All groups, except for males and females = 61 years old, showed significant improvements in mHHS, NAHS, HOS-SSS, and VAS at minimum 2- and 5-year follow-up when compared with preoperative levels (P < 0.001). Males = 61 years old showed a significant improvement in VAS at minimum 2-year follow-up but showed significant improvements in all PROs at minimum 5-year follow-up (P < 0.05). Females = 61 years old showed significant improvements in mHHS at minimum 2-year follow-up (P = 0.032). Comparison between sexes in similar age groups revealed there were no significant differences between females and males except, there were more females < 21 years old than males that required a revision arthroscopy (P = 0.015). Comparison between age groups within the same sex revealed there were significant differences in all PROs at latest follow-up for both females and males depending on age (mHHS, P < 0.001; NAHS, P < 0.001; HOS-SSS, P < 0.001; VAS, P = 0.005). Within males and females separately, and when both were combined, patients < 21 years old had significantly better outcomes compared to other age groups, while patients = 61 years old had significantly worse outcomes (P < 0.05).

Conclusions

Following primary hip arthroscopy, patients younger than 21 years old reported higher PROs. Female patients reported similar levels of improvement in PROs compared to their male counterparts. The general conversion rate to total hip arthroplasty was 5.2%.