Summary

At a 10-year follow-up, the location of cam lesions did not significantly impact conversion to total hip arthroplasty, revision surgery, or improvement in patient-reported outcomes, though higher BMI and female sex were associated with worse long-term results.

Abstract

Objectives: This study aims to analyze the association between radiographic cam location and hip survivorship, as well as postoperative patient-reported outcomes (PROs), at a 10-year follow-up.

Methods

The authors reviewed prospective data from patients with cam lesions identified radiographically who underwent hip arthroscopy for femoroacetabular impingement syndrome. Patients were divided into three cohorts according to cam lesion location: superolateral, anterolateral, or anterior. Evaluated outcome measures included conversion to total hip arthroplasty (THA), revision rates, and patient-reported outcomes (PROs) including modified Harris Hip Scores (mHHS) and Non-Arthritic Hip Scores (NAHS). All data was collected preoperatively and at the 10-year minimum follow-up. All statistical analysis was considered significant at P < 0.05.

Results

A total of 156 patients were included in this analysis. The average age of the cohort was 38.93 ± 12.84 years, with a mean BMI of 24.83 ± 4.07. The mean follow-up period was 11.66 ± 1.08 years. Among these patients, 93 (59.6%) had superolateral cam lesions, 37 (23.7%) had anterolateral lesions, and 26 (16.7%) had anterior lesions. The revision rates over a 10-year period were 0% for anterior lesions, 8.3% for anterolateral lesions, and 5.6% for superolateral lesions (P = 0.428). The conversion rates to total hip arthroplasty (THA) were 8.7% for anterior lesions, 2.8% for anterolateral lesions, and 10.8% for superolateral lesions (P = 0.423) (Table 1). There were no significant differences in the 10-year improvement in mHHS (P = 0.493) or NAHS (P = 0.408) across the cam lesion positions (Table 1). However, significant associations were found between higher BMI and worse PROs (mHHS, P < 0.0001; NAHS, P < 0.0001), as well as between female sex and worse outcomes (mHHS, P = 0.042; NAHS, P = 0.021).

Conclusions

The presence of a superolateral cam lesion is not significantly associated with a higher likelihood of conversion to THA or revision surgery within 10 years following hip arthroscopy compared to anterior and anterolateral lesions. The location of the cam lesion did not influence the improvement in PROs at the 10-year follow-up. However, higher BMI and female sex were associated with worse long-term outcomes.