EP3.39 Comparing 2-year Outcomes Between Historical and Contemporary Cohorts: Surgical Evolution of Femoracetabular Impingement Resection
Abstract
Abstract Purpose To compare 2-year patient-reported outcomes (PROs) following hip arthroscopy for femoroacetabular impingement syndrome (FAIS) between two surgical-era cohorts—a contemporary cohort with a minimum 2-year follow-up and a historical cohort treated more than 10 years earlier with available 2-year follow-up—and to evaluate the association between radiographic correction and early PROs. Methods A single-surgeon, prospectively maintained database was queried for FAIS cases performed between 2010–2013 (HC) and 2019–2023 (CC). The primary outcomes were the 2-year modified Harris Hip Score (mHHS) and the Non-Arthritic Hip Score (NAHS). Secondary outcomes included change from baseline to 2 years (ΔmHHS, ΔNAHS) and radiographic parameters (pre-/postoperative alpha angle on AP, 45° Dunn, and 90° Dunn views; lateral center-edge angle [LCEA]). Between-cohort comparisons used t-tests and χ2 tests. Multivariable linear regression adjusted for baseline score, age, sex, and BMI. Results Of 183 eligible patients, propensity score matching yielded 38 matched pairs (n=76). Baseline mHHS (57.2 vs 58.2, p=0.77) and NAHS (55.6 vs 54.6, p=0.79) were comparable between cohorts. The HC demonstrated greater improvement in mHHS (27.9 ± 15.7 vs 13.3 ± 15.9; p=0.006) and NAHS (31.7 ± 15.1 vs 12.7 ± 21.4; p=0.002). Revision labral repair occurred in two HC and four CC patients, with no conversions to total hip arthroplasty. Preoperative radiographic parameters were similar. Postoperatively, the CC demonstrated greater alpha angle correction on AP (Δ7.9° vs –0.05°, p=0.019) and 90° Dunn views (Δ13.9° vs –0.9°, p=0.005), with no difference on 45° Dunn (p=0.78). Change in LCEA did not differ between cohorts (p=0.708). Conclusion Greater radiographic correction alone does not correlate with superior early PROs following hip arthroscopy for FAIS. Optimal outcomes likely depend on a comprehensive surgical approach beyond osseous resection, warranting further investigation. Level of Evidence III