EP3.42 Fibromyalgia Is Associated With Inferior 10-Year Outcomes After Primary Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Propensity-Matched Cohort Study
Abstract
Abstract Purpose Centralized pain syndromes such as fibromyalgia may impair recovery after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), yet their long-term impact on surgical outcomes is unclear. The purpose of this study was to compare minimum 10-year outcomes between patients with fibromyalgia and propensity-matched controls undergoing primary hip arthroscopy for FAIS. Methods A retrospective review of a prospectively maintained database identified patients who underwent primary hip arthroscopy for FAIS by a single surgeon between 2011 and 2016. Patients with a physician-diagnosed history of fibromyalgia and minimum 10-year follow-up were propensity matched 1:2 to controls by age, sex, body mass index, and baseline Non-Arthritic Hip Score (NAHS). Outcomes included 10-year NAHS and modified Harris Hip Score (mHHS), achievement of minimal clinically important difference (MCID) and patient acceptable symptom state (PASS), radiographic correction, and reoperation. Linear and logistic mixed-effects regression models accounted for matched clustering. Results 18 patients with fibromyalgia were matched to 36 controls (54 hips; 100% follow-up). Baseline characteristics were similar. At 10 years, fibromyalgia patients demonstrated lower adjusted NAHS (73.1 vs 85.6; mean difference, −12.4; 95% CI, −19.8 to −5.1; P = .002) and mHHS (75.4 vs 86.1; mean difference, −10.6; 95% CI, −18.6 to −2.6; P = .014). MCID achievement did not differ significantly. However, fibromyalgia patients were less likely to achieve PASS for mHHS (38.9% vs 77.8%; OR, 0.18; P = .005) and NAHS (33.3% vs 86.1%; OR, 0.08; P < .001). Radiographic correction and reoperation rates were similar. Conclusion Fibromyalgia independently predicts inferior long-term function and reduced likelihood of achieving an acceptable symptom state after hip arthroscopy for FAIS despite equivalent structural correction.