Summary

Patients who underwent unilateral and bilateral hip arthroscopy for FAI showed a significant and comparable improvement at minimum 5-year follow-up.

Abstract

Introduction

Bilateral hip symptoms are a common finding in patients with femoroacetabular impingement (FAI). There is a paucity of literature regarding mid-term outcomes in patients undergoing staged bilateral hip arthroscopy. The purpose of this study is to present and compare minimum 5-year outcomes between patients who underwent bilateral hip arthroscopic surgery for FAI to a propensity-score matched unilateral hip arthroscopy benchmark control group and, to investigate the impact of time between staged bilateral procedures.

Methods

Data from patients who underwent primary hip arthroscopies from June 2008 to October 2018 were retrospectively collected. Patients who underwent bilateral hip arthroscopy with minimum 5-year follow-up for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), Visual Analog Scale (VAS), and patient satisfaction scores were included. The bilateral cohort was propensity-matched 1:1 to a control group that underwent unilateral hip arthroscopy based on age, sex, and body-mass index (BMI).

Results

193 patients (386 hips) were included with a mean age of 33.5 ± 13.6 years and BMI of 25.5 ± 5.3 kg/m2. All 386 hips were propensity-matched to the benchmark control group of patients who underwent unilateral hip arthroscopy. Both groups achieved significant improvement in patient reported outcomes (PROs) at minimum 5-years follow-up, with comparable results between groups. There was no significant difference in rates of achieving PASS and SCB for any PROs (p>0.05) Patients in the bilateral group with less than 9 weeks between surgical procedures had higher rates of achieving PASS for HOS-SSS (p=0.041).

Conclusion

Patients who underwent unilateral and bilateral hip arthroscopy for FAI showed a significant and comparable improvement at minimum 5-year follow-up. Bilateral presenting patients who underwent staged procedures less than 9 weeks apart met clinically significant thresholds at a higher rate compared to bilateral patients who had their procedures spaced more than 9 weeks apart.