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Impact of Preoperative and Residual Alpha Angle on Outcomes After Hip Arthroscopy
Jasmine Puria1, Daniel Puczko2, Christopher S Frey3,4
1College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
Purpose:
Femoroacetabular impingement syndrome (FAIS) can lead to pain, decreased mobility, and difficulty in performing activities of daily living. Symptoms can improve with surgery, often hip arthroscopy with osteoplasty. Radiological parameters such as the alpha angle can be utilized to determine the degree of cam morphology and assess resection after surgery. This study sought to evaluate the relationship between pre-operative alpha angle and the change in alpha angle on patient satisfaction post-surgical correction using the 12-item International Hip Outcome Tool (iHOT-12).
Patients And Methods:
Patients that underwent primary or revision hip arthroscopy with osteoplasty for FAIS by a single fellowship-trained surgeon at a tertiary academic center from September 1, 2014 to April 1, 2024 were eligible for this retrospective cohort study. Data collected included type of operation, preoperative and postoperative alpha angle, 6-month iHOT-12 scores, and demographic data. Multivariate proportional odds regression analyses were conducted to assess whether preoperative alpha angle and the change in alpha angle from pre- to post-operative were predictive of 6-month iHOT-12 scores. Additionally, Pearson correlation coefficients were reported for 6-month iHOT-12 association with preoperative alpha angle and alpha angle delta.
Results:
507 patients and 541 operative hips were identified during the study period. 99 (18%) hips were included in the final analysis. Mean alpha angle was 60.9 (SD = 9.8) preoperatively and 44.4 (SD = 6.1) postoperatively with a mean absolute change of 16.5 (SD = 8.6). The mean 6-month iHOT-12 score was 62.0 (SD = 26.9). Multivariate proportional odds regression analyses did not reveal significant predictors of 6-month iHOT-12 scores including preoperative alpha angle and alpha angle change.
Conclusion:
This study found no association between preoperative alpha angle or postoperative change in alpha angle and 6-month iHOT-12 scores. Future research on other factors such as three-dimensional morphology may be warranted.
