Short- and Medium-Term Outcomes of Hip Arthroscopy in Patients under 18 Years

Femoroacetabular impingement (FAI) is a common cause of hip pain in adolescents and may lead to osteoarthritis. While conservative treatments are the first-line option, arthroscopy offers a minimally invasive approach to repairing labral tears and correcting bone deformities. This study analyzes the outcomes of patients under 18 years old who underwent hip arthroscopy for FAI in a multicenter retrospective cohort with a minimum 5-year follow-up.

This was a retrospective multicenter study. Patients under 18 with a confirmed FAI diagnosis and a minimum follow-up of 5 years were included. Clinical and radiological findings, demographics, and functional outcomes (Tegner, modified Harris Hip Score [mHHS], Hip Outcome Score [HOS], and International Hip Outcome Tool-33 [iHOT-33]) were analyzed pre- and postoperatively. The percentage of patients who achieved improvements exceeding the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) thresholds was also calculated.

A total of 90 hips were included (mean age, 16.1 ± 1.5 years). At 5 years, all functional scores improved significantly: mHHS (68.1 ± 16.3 to 96.6 ± 8.7, p < 0.001), iHOT-33 (51.7 ± 20.3 to 85.6 ± 10.8), HOS activities of daily living (71.2 ± 16.6 to 96.1 ± 4.9), and HOS sports subscale (50.3 ± 21.1 to 92.7 ± 8.5). Cam-type deformities were the most prevalent (68.8%), followed by mixed morphologies (22.2%). Labral lesions were repaired in 96.3% of cases, with a mean of 2.9 anchors per repair. The alpha angle significantly decreased postoperatively (62.3° ± 11.8° to 45.6° ± 8.4°, p < 0.001). At 5 years, 85%-94% of patients surpassed the MCID thresholds and 33%-77% reached the SCB thresholds depending on the outcome measure.

Hip arthroscopy was associated with significant functional improvement and symptom relief in adolescents with FAI at a minimum 5-year follow-up. Further studies with longer follow-up are necessary to determine its long-term role in joint preservation. Notably, systematic radiological assessment of osteoarthritis progression (e.g., joint space width, Tönnis grade) was not available across all participating centers and could therefore not be analyzed, which constitutes an important limitation of this study.