Purpose

To report minimum 10-year follow-up results and survivorship of hip arthroscopy with concomitant periacetabular osteotomy (PAO) to treat acetabular dysplasia and intra-articular pathologies, such as femoroacetabular impingement (FAI) and labral tears.

Methods

Data from November 2010 to February 2014 was prospectively collected and retrospectively reviewed to identify patients undergoing primary hip arthroscopy with concomitant PAO. Patients were included in the present analysis if they had preoperative and minimum 10-year patient reported outcomes (PROs) documented for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Scored Sports-Specific Subscale (HOS-SSS), and pain on a visual analog scale (VAS), as well as the International Hip Outcome Tool (iHOT-12) and patient satisfaction score on a 0-10 scale.

Results

22 patients were eligible for analysis and 15 had completed minimum 10-year follow-up data. The mean lateral center-edge angle (LCEA) of all included hips in the analysis increased from 14.4 to 30.6 degrees postoperatively (p < 0.05) and the anterior center-edge angle (ACEA) increased from 13.3 to 30.6 degrees postoperatively (p < 0.05). There was significant improvement in all PROs from baseline to minimum 10-year follow-up (p < 0.05). A high percentage of patients met or exceeded MCID for mHHS, NAHS, HOS-SSS, and VAS. Four patients (26.7%) converted to total hip arthroplasty (THA) at mean 63.8 months postoperatively. Additionally, 2 patients (13.3%) underwent subsequent ipsilateral revision hip arthroscopy at mean 57.5 months postoperatively.

Conclusions

Hip arthroscopy combined with PAO can safely treat patients with dysplasia and intra-articular pathologies, such as labral tears and femoroacetabular impingement (FAI). These patients can experience significant long-term improvement compared to baseline, with a 73% survivorship rate.