Summary: Our study sets outs to assess the clinical outcome and complications rates between patients undergoing simultaneous versus staged surgery for bilateral hip femoroacetabular impingement.

Introduction

Femoroacetabular impingement (FAI) typically involves both hips and presents a surgical dilemma when symptomatic at the same time. Bilateral simultaneous surgery can reduce the overall rehabilitation period compared to a staged surgery. However, the disadvantages are longer surgical time and possible higher complications. We hypothesize that there is no difference in the outcome and complication rates between bilateral simultaneous and staged surgery for FAI.

Methods

Patients who underwent simultaneous and staged bilateral primary hip arthroscopy for FAI between June 2005 and December 2018 were identified from our surgical database. Those who had their second surgery within 1 year of their index surgery were included in the staged group. The control group comprised patients who underwent a unilateral hip arthroscopy within the same time-frame. Patient Reported Outcome Measures (PROMs) including the 12-item International Hip Outcome Tool (iHOT-12), Non-Arthritic Hip (NAH) Total and Hip Disability and Osteoarthritis Outcome (HOOS) scores were collected pre-operatively and at regular intervals post-operatively up to 10 years. Two-year follow-ups scores were included in analysis if they were available, or later follow-ups if they were not. We also gathered data on complications and revision surgery rates including conversion to arthroplasty from a national registry.

Results

A total of 186 patients (372 hips) in the bilateral simultaneous and 83 patients (166 hips) in the bilateral staged were compared with 1275 patients in the unilateral group. The median duration between staged surgeries was 57 days (range 14 to 347 days). Simultaneous and staged surgeries did not differ in follow-up duration, patients’ age, gender, or body mass index, although patients in the unilateral group were older (37±12 years compared with 30±11 years in the bilateral groups; p<0.001). Two-year minimum post-operative scores in all 3 groups were significantly improved compared to their pre-operative scores (bilateral simultaneous iHOT-12 pre-op 37.0±18.7 and post-op 74.7±22.2; bilateral staged iHOT-12 pre-op 41.2±19.3 and post-op 69.4±25.6 and unilateral iHOT-12 pre-op 39.3±20.4 and post-op 75.3±23.4; p<0.001 for all changes). We found a significant difference in several 2-year minimum post-operative scores between the 3 groups after statistically adjusting for the differing pre-operative scores. Overall, the staged group performed worse in all scores (p<0.05 for all apart from HOOS Sports subscale and NAH Total scores). There was no difference in revision rates between groups, but simultaneous surgeries were less likely to undergo conversion to arthroplasty within the study’s 6.4±2.6 years follow-up duration (1.1% conversion rate for simultaneous, versus 3.6% in staged and 4.5% in unilateral; p=0.009).

Conclusion

Patient who underwent bilateral simultaneous hip arthroscopy for FAI did better in most PROM scores than staged surgery at the 2-year follow-up period, and were less likely within the study time-frame to require conversion to arthroplasty. These differences are likely due to selection for simultaneous versus staged procedures.

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A Comparison Of Perioperative Outcomes Between Patients Who Underwent Hip Arthroscopy With And Without The Pericapsular Nerve Group Block ePoster Presentation Albert A Yusupov, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Christopher J Mazzei, MD, UNITED STATES Stephen A. Hunt, MD Kimberly V Tucker, MD, UNITED STATES Anthony Scillia, UNITED STATES Patrick A Armstrong, MD, UNITED STATES Mathew S Chow, MD, UNITED STATES Richard A Stennett, MD, UNITED STATES James C Wittig, MD
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Alpha Angle More Useful Than Femoral Head-Neck Offset to Predict Intra-Articular Damage in Patients with FAI Undergoing Hip Arthroscopy Abstract Presentation 5 minutes Jacob Shapira, MD, UNITED STATES Jade S Owens, BS, UNITED STATES David R. Maldonado, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Bezalel Peskin, MD, ISRAEL Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Long Term Outcomes After Arthroscopic Treatment Of Femoroacetabular Impingement For Patients With Borderline Dysplasia Abstract Presentation 4 minutes Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Biomechanical Assessment of the Risk of Hip Injury During A 2,000m Ergometer Row Test Abstract Presentation 5 minutes Jordan Page Ankersen, BS, UNITED STATES Stephanie S Gardner, MD, UNITED STATES Bradley S Lambert, PhD, UNITED STATES Joshua D Harris, MD, UNITED STATES Patrick C. McCulloch, MD, UNITED STATES Michael R Moreno, PhD, UNITED STATES Shari Liberman, MD, UNITED STATES
Mid-Term Outcome and Strength Assessment after Proximal Rectus-Femoris-Refixation in Athletes ePoster Presentation Maximilian Hinz, MD, GERMANY Stephanie Geyer, MD, GERMANY Felix Winden, Cand Med, GERMANY Alexander Braunsperger, B.Sc., GERMANY Florian Kreuzpointner, PhD, GERMANY Benjamin Daniel Kleim, MBBS, MD, MRes, GERMANY Andreas B. Imhoff, MD, Prof. Emeritus, GERMANY Julian Mehl, MD, GERMANY
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
The Quest For Optimal Femoral Anteversion Angle Measurements: A Comparative Advanced 3D Study Abstract Presentation 6 minutes Bert Van fraeyenhove, MD, BELGIUM Annemieke Van Haver, PhD, MSc, BELGIUM Jonas Grammens, MD, BELGIUM Gino Mestach, MD, BELGIUM Jeroen Verhaegen, MD, BELGIUM Peter Verdonk, MD, PhD, BELGIUM
Assessing Risk Of Osteonecrosis Of The Hip Following Intraarticular Injections: Hyaluronic Acid Versus Corticosteroid Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Health Literacy in Hip Arthroscopy: A Quantitative Assessment of the Understandability and Readability of Online Patient Education ePoster Presentation Alan Shamrock, MD, UNITED STATES Burke Gao, MD, UNITED STATES Olivia O'Reilly, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES Robert W. Westermann, MD, UNITED STATES
Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes ePoster Presentation Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Steven Cecchi, BSc (Hons), MBBS, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter T. Annear, FRACS(Orth), AUSTRALIA
Can Hip Pain Be Treated With Tibial Malrotation Correction? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Snapping Hip Syndrome : An Uncommon Cause of Hip Pain ePoster Presentation Pollyanna Christine Ferreira Frazão, MD, PORTUGAL Rui Cardoso, MD, PORTUGAL Daniela Roque, MD, PORTUGAL Diogo Rocha Carvalho, Md, MsD, PORTUGAL André Santos, MD, PORTUGAL Sérgio Pita, MD, PORTUGAL Filipe Sá Malheiro, MD, PORTUGAL Tiago Pato, PORTUGAL Carlos Filipe Gonçalves João, MD, PORTUGAL Carlos Almeida, PORTUGAL

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Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged?

Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged?

Introduction

Methods

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Conclusion

More 2021 Congress Hip Abstract Presentations

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Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged?

Treatment of Bilateral Hip Femoroacetabular Impingement: Simultaneous or Staged?

Introduction

Methods

Results

Conclusion

More ISAKOS 2021: Global Content