Summary

Patients with acetabular retroversion who present with FAIS and labral tears can be safely treated using advanced hip arthroscopic techniques without anteverting PAO in a high-volume surgeon’s hands.

Abstract

Purpose

(1) To report and analyze long-term patient-reported outcome scores (PROs) in patients with FAIS and labral tears in the setting of acetabular retroversion following hip arthroscopy and (2) compare these PROs with those of a propensity-matched benchmark control group without acetabular retroversion.

Methods

Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy for FAIS and labral tear treatment between June 2008 and December 2013. Retroversion was determined based on the presence of an ischial spine sign, >20% crossover sign, and presence of posterior wall sign. Outcomes measured included pre- and post-operative PROs, patient satisfaction scores, rates of achieving the minimal clinically important difference (MCID), the patient acceptable symptomatic state (PASS), arthroplasty-free-survivorship, and rate of revision hip arthroscopy. Propensity score matching was utilized to identify a control group without retroversion and were matched 1:1.

Results

A total of 95 hips with acetabular retroversion were matched to a control group. The groups showed no difference between demographic variables. Significant improvements were seen in all PROs collected in both groups, with a survivorship of 96% in both cohorts. No significant difference was found in the rates of achieving MCID or PASS between cohorts, but there was found to be a significant difference in rates of achieving SCB for pre-operative mHHS, with patients in the RA cohort achieving PASS at a higher rate than control patients (p = 0.04).

Conclusion

Patients with acetabular retroversion who present with FAIS and labral tears can be safely treated using advanced hip arthroscopic techniques without anteverting PAO in a high-volume surgeon’s hands. Patients with acetabular retroversion demonstrated favorable PROs, low rate of revision arthroscopy, and conversion to THA at long-term follow-up, which is consistent with a propensity-matched control group without acetabular retroversion.