Isolated Acetabuloplasty for Femoroacetabular Impingement: Favorable Patient Reported Outcomes and Sustained Survivorship at Minimum 5-Year Follow-up.

Abstract

PURPOSE\nEvaluate minimum 5-year outcomes and conversion rates to total hip arthroplasty (THA) for the treatment of femoroacetabular impingement (FAI) syndrome with an isolated acetabular osteoplasty.\n\n\nMETHODS\nPatients undergoing hip arthroscopy with an isolated acetabular osteoplasty from March 2009 to June 2014 for FAI syndrome with pincer and/or cam morphology and a labral tear were identified. Patients who underwent a femoroplasty, had previous hip conditions, ipsilateral hip dysplasia, Tonnis >2, or had prior ipsilateral hip surgery were excluded. Patient reported outcomes collected included Patient Reported Outcome Measurement Information System (PROMIS) scores specific to physical functioning and pain interference, the modified Harris Hip Score (mHHS), the International Hip Outcome Tool (iHOT-12), Hip Outcome Score - Activities of Daily Living (HOS-ADL), Hip Outcome Score - Sport-Specific Subscale (HOS-SSS), and the Numeric Pain Rating Scale (NPRS). Patients were also queried about secondary surgeries and conversion to total hip arthroplasty.\n\n\nRESULTS\n86 patients were identified at minimum 5-year follow-up (average 7.4 years). The average patient age was 39.8 ± 12.3 years, 70.9% were female, and 7% were Tonnis 2. Mean patient reported outcomes were 52.0 ± 8.9 for PROMIS-PF, 39.6 ± 7.5 for PROMIS-PI, 78.7 ± 12.0 for mHHS, 73.3 ± 23.1 for iHOT-12, 89.9 ± 12.0 for HOS-ADL, and 81.4 ± 21.0 for HOS-SSS. 72.1% of patients achieved a patient acceptable symptomatic state (PASS) according to previously established PASS scores for FAI syndrome treated with hip arthroscopy at minimum 5-year follow-up. The overall rate of revision arthroscopy was 3.5% and the rate of conversion to THA was 5.8%.\n\n\nCONCLUSIONS\nAn isolated acetabular osteoplasty can provide sustained clinical benefits for the treatment of FAI syndrome with labral tears, with good to excellent PROs and PASS rates and a low rate of conversion to THA at minimum 5-year follow-up.\n\n\nLEVEL OF EVIDENCE\nIV, case series.