TP8.5 1-Year Outcomes Predict 15-Year Outcomes in Patients Undergoing Primary Hip Arthroscopy for Femoroacetabular Impingement

Abstract

Abstract Purpose Although short- and long-term outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS) have been well described, the relationship between early postoperative improvement and long-term clinical outcomes remains unclear. The purpose of this study was to determine whether 1-year improvement in patient-reported outcomes (PROs) predicts clinical outcomes and survivorship at 15 years after primary hip arthroscopy for FAIS. We hypothesized that greater 1-year improvement would predict superior long-term outcomes and survivorship. Methods Patients who underwent primary hip arthroscopy for FAIS by a single surgeon with minimum 15-year follow-up were retrospectively reviewed. Outcomes included the modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) collected preoperatively and at 6 months, 1, 2, 5, 10, and 15 years. Patients were stratified into high improvement (HI) and low improvement (LI) groups based on the median 1-year change in mHHS. Outcomes were compared longitudinally. Multivariable regression, Kaplan–Meier analysis, and Cox proportional hazards modeling were performed to identify predictors of 15-year outcomes and failure (revision arthroscopy or conversion to total hip arthroplasty). Results A total of 128 patients (64 HI, 64 LI) with a mean follow-up of 15.0 ± 0.6 years were included. Both groups improved significantly from baseline at all time points. The HI group demonstrated greater early improvement and superior long-term outcomes. At 15 years, the HI group had higher mHHS (91.4 ± 15.5 vs 83.0 ± 18.1; p = 0.006) and NAHS (89.9 ± 16.7 vs 81.1 ± 19.9; p = 0.008). One-year PROs predicted 15-year outcomes (mHHS: β = 0.37, p < 0.001; NAHS: β = 0.35, p = 0.002) and were associated with reduced risk of failure (mHHS: OR 0.95, p = 0.001; NAHS: OR 0.96, p = 0.027). Survivorship was higher in the HI group (p = 0.03), while the LI group had increased risk of failure (HR 2.33; p = 0.036). Male sex and lower BMI were associated with superior outcomes. Conclusion Greater improvement within the first postoperative year is associated with superior 15-year outcomes and reduced risk of failure. Therefore, early recovery may serve as a key prognostic indicator following hip arthroscopy for FAIS.