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Hip Arthroscopy for Femoroacetabular Impingement Syndrome Results in 2 Recovery Patterns Based on Preoperative Pain
Maarten A Röling1, Brechtje Hesseling2, Nina M C Mathijssen2
1Department of Orthopaedic Surgery, Gelre Hospital Apeldoorn, Apeldoorn, The Netherlands.
Purpose:
To analyze whether subgroups of patients could be distinguished with different functional recovery trajectories after hip arthroscopy for femoroacetabular impingement (FAI) syndrome and to identify differences between those subgroups using data from our prospective cohort registration.
Methods:
We retrospectively reviewed the prospectively registered data of patients who had undergone hip arthroscopy for FAI syndrome in our clinic from 2015 through 2018. Latent class growth modeling and growth mixture modeling were used to identify and classify groups of patients according to the trajectory of functional recovery using the Hip Outcome Score-Activities of Daily Life (HOS-ADL). We used univariable analysis and descriptive statistics to explore whether differences in group membership could be identified.
Results:
A total of 100 patients were analyzed. Growth mixture modeling identified 2 main types of recovery pattern after surgery: patients in whom the HOS-ADL improved significantly after surgery to 90, whom we called the "improvers" (with fast initial improvement within 3 months that is maintained during follow-up), and patients who did not significantly benefit from surgery (with only mild improvement in the HOS-ADL at 3 months and no further change during follow-up), whom we called the "non-improvers." Univariable analysis and comparison of differences between subgroups showed higher preoperative visual analog scale scores for pain and more intraoperative arthrosis of the femoral head for the non-improvers.
Conclusions:
We identified 2 main types of recovery pattern after arthroscopic treatment of FAI syndrome: improvers and non-improvers. Both groups recover in a different manner postoperatively. Preoperative pain and intraoperative arthrosis of the femoral head differed in the non-improvers compared with the improvers.
Level Of Evidence:
Level III, retrospective cohort study.
