Outcome of arthroscopic treatment for symptomatic femoroacetabular impingement

Recently, arthroscopic-based treatment for hip-related pain with radiological findings of femoroacetabular impingement and labral lesions has been developed.We aim to present clinical outcome in a single centre patient cohort of patients treated arthroscopically for hip-related pain due to femoroacetabular impingement.

A total of 117 consecutive patients operated in 2009-2011 were included in this prospective case series (41% male; mean age 37 years; (range 15-70). The indication for arthroscopic treatment of hip-related pain was mechanical hip symptoms and radiological findings of femoroacetabular impingement.To evaluate hip function and pain level at 1-year and 2-5 years follow up (FU) mHHS (Modified Harris Hip Score), HOS (Hip Outcome Score) and a Numeric Rating Scale (NRS) pain score were used.

Labral tears were seen in 91% of the hip arthroscopies. Cartilage lesions (ICRS grade 2 and above) were seen at the acetabular and femoral articular surfaces in 79% and 15% of cases, respectively. The therapeutic procedures were in 99% of the arthroscopies osteochondroplasty and/or acetabular rim-trimming. In 77% of procedures labral reattachment was performed. The patient evaluated outcome demonstrated significant increases in mHHS and HOS at 1-year follow up and at final FU compared to preoperatively (1 yr: mHHS: 72.1 to 85.3, HOS: 71.4 to 85.1; final FU: mHHS: 72.1 to 83.8, HOS: 71.4 to 83.7). Pain levels decreased significantly from preoperatively to follow ups. Five patients underwent total hip replacement within the follow up period after hip arthroscopy.

Arthroscopic treatment of femoroacetabular impingement improves patient evaluated outcomes. Further studies are needed to determine failure rates and risk factors.