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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The Effect Of Osteochondroplasty On Time To Reoperation After Arthroscopic Management Of Femoroacetabular Impingement Abstract Presentation 5 minutes Jeffrey Kay, MD, CANADA Nicole Simunovic, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
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Does MRI Scan Enable Optimally Informed Pre-Operative Planning In Hip Arthroscopy? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Fadi Hindi, BM, MRCS, UNITED KINGDOM Andrew Langdown, BSc MB ChB FRCS(Tr&Orth), UNITED KINGDOM
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
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL
Risk Factors For Early Conversion To Hip Arthroplasty Following Hip Arthroscopy: A Matched Cohort Analysis Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Use Of Preoperative Magnetic Resonance Imaging To Predict Clinical Outcomes Following Core Muscle Injury Repair ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Jennifer Kurowicki, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Edward Milman, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES
Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy? Abstract Presentation 5 minutes Michael Peter Kucharik, BS, UNITED STATES Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Christopher T Eberlin, BS, 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
Sex- And Age-Based Differences In Outcomes And Survivorship Following Primary Hip Arthroscopy At Short And Mid-Term Follow-Up: A Comparative Analysis ePoster Presentation David R. Maldonado, MD, UNITED STATES Jade S Owens, BS, UNITED STATES Cammille Go, BA, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain? Abstract Presentation 5 minutes Daniel Curtis, MD, UNITED STATES William Michael Pullen, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES
Can Hip Microinstability Be Predicted By Hip Range Of Motion Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Justin Hopkins, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Andrea Finlay, PhD, UNITED STATES Nicole Segovia Pham, MPH, UNITED STATES
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture ePoster Presentation George Bradley Reahl, MS, UNITED STATES Michael McTague, MPH, UNITED STATES Nishant Suneja, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
Endoscopic Shelf Acetabuloplasty Concomitant With Labral Repair, Cam Osteoplasty, And Capsular Plication For Treating Artistic Dancers In The Setting Of Acetabular Dysplasia: A Case Series Abstract Presentation 4 minutes Soshi Uchida, MD, PhD, JAPAN Yoichi Murata, MD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Tsukamoto Manabu, MD, PhD, JAPAN Akihisa Hatakeyama, MD, JAPAN Shiho Kanezaki, MD, PhD, JAPAN Akinori Sakai, MD, PhD, JAPAN
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
A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post ePoster Presentation Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES
Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty ePoster Presentation Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY Alexander Zimmerer, MD, GERMANY

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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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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