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Updated: Sep 14, 2026
In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
The Femoral Impingement Index Predicts Inferior Clinical Outcomes in Men Undergoing Hip Arthroscopy for
Ronak M Patel1, Ryan S Selley1, Hayden P Baker1
1Sports Medicine and Shoulder Surgery Service, Hospital for Special Surgery, New York, New York, U.S.A.
Purpose:
To evaluate the association of femoral version, McKibbin index, and femoral impingement index (FII) on patient-reported outcomes after primary hip arthroscopy for femoroacetabular impingement syndrome.
Methods:
We retrospectively reviewed prospectively collected data from a hip preservation registry. Inclusion criteria included Tönnis grade ≤1 and a minimum 2-year follow-up. Computed tomography-based morphologic parameters and validated patient-reported outcomes (modified Harris Hip Score, hip outcome score-activities of daily living, hip outcome score-sport-specific subscale, and International Hip Outcome Tool) were analyzed. Patients were stratified by femoral version, McKibbin index, and FII (low <45°, moderate 45°-75°, high >75°). Multivariable regression adjusted for age and preoperative scores was used to assess outcomes and achievement of the minimal clinically important difference.
Results:
A total of 456 hips met inclusion criteria, with significant improvements across all outcome measures at a mean follow-up of 2.6 years (P < .001). No significant differences in outcomes were observed when stratified by femoral version or McKibbin index. However, patients with high FII (>75°), predominantly men, displayed lower net improvement in hip outcome score-sport-specific subscale scores (14.6 vs 28.1 and 33.4 in moderate and low FII groups, respectively; P = .024) and reduced odds of achieving the minimal clinically important difference (53% vs 75% in low FII group; P = .047). Among men, increasing FII was associated with significantly lower improvements in hip outcome score-activities of daily living and hip outcome score-sport-specific subscale scores and lower likelihood of achieving minimal clinically important difference (adjusted odds ratio 0.19; 95% confidence interval 0.04-0.83; P = .028).
Conclusions:
In this cohort, a high FII (>75°) was associated with significantly lower net patient-reported outcome measure improvement in male patients.
Level Of Evidence:
Level III, retrospective cohort study.
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