Purpose
The effects of generalized joint laxity, or joint hypermobility, on the hip joint is not well understood. Traditionally, the Beighton score has been used to test for the presence of and quantify the level of hyperlaxity in various joints and has been associated with increased Femoroacetabular translation. It is unclear how this hypermobility affects functional outcomes following hip arthroscopy for Femoroacetabular impingement (FAI) with labral repair. The purpose of this study was to evaluate the association between preoperative Beighton scores measuring joint laxity and patient reported outcomes (PROs) after hip arthroscopy for FAI.
Methods
Patients who underwent primary hip arthroscopy with labral repair for treatment of FAI with the senior surgeon between January 2016 and December 2018 were identified. Exclusion criteria included prior ipsilateral hip surgery, presence of advanced osteoarthritis (Tonnis grade >1 or joint space < 2mm), or history of confounding injury or prior hip conditions (SCFE, LCP, etc.). Minimum 2-year PROs were collected, including mHHS, HOS-ADL, and HOS-Sport. Patient outcomes were compared between patients with joint hypermobility (HM)(Beighton score 5) and patients with Beighton score < 5 (NHM).
Results
Of the 278 patients that med inclusion criteria, 226 (81%) were available for 2-year follow-up. Beighton exam was completed on all patients with 197 hips NHM and 24 hips HM. Females were significantly more likely to have a positive Beighton compared to males (P< 0.01). One patient (4.5%) in the HM group required a subsequent surgery (THA) and 13 (7%) in the NHM group had a subsequent surgery (1 PAO, 5 revisions, 7 THA). Mean follow-up in the NHM group was 3.8±1 years and 3.5±1 in the HM group (p=0.23). There was no difference in HOS ADL (91 vs 86), HOS Sport (81 vs 74), mHHS (86 vs 87), patient satisfaction with outcome (10 vs 9) or Tegner Activity Level (5 vs 4) when comparing the NHM group to the HM group. There was no difference between groups in PASS or MCID rates (p>0.05 for all) for HOS-ADL, HOS-Sport, or mHHS
Conclusion
In this study, patients with HM had fewer subsequent surgeries and lower outcome scores; however, they were not significantly different. Hip arthroscopy for FAI with labral repair in the HM population resulted in excellent outcomes and a low failure rate.