2017 ISAKOS Biennial Congress ePoster #712

 

Predicting Excellent Clinical Outcome Of Hip Arthroscopy for Femoroacetabular Impingement

Yoichi Murata, MD, Kitakyushu, Fukuoka JAPAN
Hajime Utsunomiya, MD, PhD, Tokyo , Tokyo JAPAN
Hitoshi Suzuki, MD, PhD, Kitakyushu, Fukuoka JAPAN
Akihisa Hatakeyama, MD, Kitakyushu, Fukuoka JAPAN
Shiho Kanezaki, MD, PhD, Kawasaki, Kanagawa JAPAN
Cecilia Pascual-Garrido, MD, Aurora, CO UNITED STATES
Akinori Sakai, MD, PhD, Kitakyushu, Fukuoka JAPAN
Soshi Uchida, MD, PhD, Kitakyushu, Fukuoka JAPAN

Wakamatsu Hospital of University of Occupational and Environmental Health, Kitakyushu, Fukuoka, JAPAN

FDA Status Not Applicable

Summary

Higher preoperative MHHS, bigger Alpha angle and AIIS type I are predictive of excellent prognosis following arthroscopic FAI correction.

Abstract

Background

Recent studies have shown the success rate of hip arthroscopic treatment for femoroacetabular impingement varies from 68 to 96 % and this variation may arise from differences in patient selection and surgical technique. Predictors of poor clinical outcome are severe cartilage damage, untreated anterior inferior iliac spine impingement and residual cam lesion. However, there is a paucity of knowledge regarding the factors of excellent clinical outcomes following hip arthroscopy.

Hypothesis

Specific clinical characteristics and radiographic parameters correlate with and predict an excellent clinical outcome after hip arthroscopy for FAI.

Purpose

To determine the factors predicting excellent prognosis.
Study design: Case control study; Level of evidence, 3
Subject and Methods: 108 FAI patients undergoing arthroscopic FAI correction and labral preservation surgery between 2009 and 2014 were retrospectively reviewed. We defined excellent as the postoperative clinical outcomes for both modified Harris Hip Score (MHHS) and Non Arthritic Hip Score (NAHS) were their maximal score at minimum 2 year follow-up, and patients with sub-maximal scores as the control group. Gender, mean age, body mass index (BMI) at the time of surgery, period from onset to surgery, preoperative radiographic parameters, anterior inferior iliac spine (AIIS) type based on 3 dimension computed tomography (3D-CT) and preoperative MHHS and NAHS were assessed.

Results

Complete follow-up data were available for 108 patients (93.1%). Of the 108 patients who were eligible for the minimum two-years follow-up, 66 (61.1%) were male and 42 (38.9%) were female, and their average age was thirty-seven years (range, 13 to 76). Excellent group consisted of 44 patients (40.7%) and control group included 64 patients (59.3%). Preoperative predictors for excellent clinical outcome were younger age (=29.5 years, p<0.01)), shorter time from onset to operation (=6.5 months, p=0.012), higher preoperative clinical outcome scores (MHHS > 72.3 points, p<0.01, NAHS > 74.4 points, p<0.01), smaller alpha angle (=57.5 degrees, p=0.00) and AIIS type I (p=0.03).

Conclusions

Younger age, shorter period from onset of symptoms to operation, higher preoperative clinical outcome scores, preoperative smaller alpha angle, AIIS type I are predictive of excellent prognosis following arthroscopic FAI correction.