EP8.76 Long Term Outcomes of Young Adults Undergoing Primary Hip Arthroscopy: A 15-Year Follow-Up Study

Abstract

Abstract Purpose Hip arthroscopy is an established treatment for femoroacetabular impingement syndrome (FAIS); however, the durability of clinical improvement in young adults remains incompletely defined. Because these individuals undergo surgery early in life, long-term joint preservation and sustained symptom relief are critical. The purpose of this study was to evaluate 15-year survivorship, patient-reported outcomes (PROs), and clinically meaningful improvement (MCID) following primary hip arthroscopy in young adults with FAIS, and to identify patient factors associated with long-term outcomes. We hypothesized that patients would demonstrate durable improvement and high survivorship. Methods Patients aged 18-40 years who underwent primary hip arthroscopy for FAIS between 2007-2011 with minimum 15-year follow-up were included. Exclusion criteria included hip dysplasia (lateral center-edge angle <20°), Tönnis grade >1, and prior ipsilateral hip surgery. PROs included the modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS), along with MCID achievement. Survivorship was defined as freedom from revision arthroscopy or conversion to total hip arthroplasty (THA). Regression analyses evaluated predictors of outcomes. Results Seventy-eight patients (mean age 30.3 ± 4.8 years; 59.0% female) were analyzed at a mean follow-up of 15.0 ± 0.7 years. Significant improvements were observed in mHHS (52.6 ± 12.2 to 89.4 ± 16.7) and NAHS (48.5 ± 11.3 to 88.3 ± 16.7) scores (p < 0.001). PROs improved rapidly within 2 years, demonstrated transient mid-term decline, and stabilized long term. MCID achievement remained high at 15 years (mHHS 98.7%, NAHS 96.2%). Survivorship was 86.3%, with 6.4% converting to THA and 9.0% undergoing revision. Failures occurred early (mean 1.7 ± 1.5 years to revision; 6.1 ± 6.1 years to THA). Male sex predicted improved outcomes, while higher BMI and older age predicted worse outcomes (p ≤ 0.003). Conclusion Primary hip arthroscopy for FAIS in young adults provides durable improvement and high survivorship at 15 years. Outcomes follow a trajectory of early improvement, mid-term attenuation, and long-term stabilization. Lower BMI, younger age, and male sex are associated with superior outcomes, while failures typically occur early. These findings support hip arthroscopy as an effective joint-preserving intervention in appropriately selected patients.