Ten-year outcomes of hip arthroscopy for femoroacetabular impingement with osteoarthritis: Sustained functional benefits but high conversion to total hip arthroplasty

IF 5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-05-27 DOI:10.1002/ksa.12709

Sarantos Nikou, Carl Sandlund, Ida Lindman, Per-Erik Johansson, Axel Öhlin, Louise Karlsson, Mikael Sansone

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引用次数: 0

Abstract

Purpose

To evaluate the long-term clinical and radiographic outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients with mild to moderate osteoarthritis (OA). The hypothesis is that patients with FAIS and mild to moderate OA would experience sustained improvements in iHOT-12 at 10-year follow-up, despite natural OA progression.

Methods

This prospective cohort study included 75 patients (80 hips) with FAIS and radiographic signs of mild to moderate OA (Tönnis grade 1 or 2) who underwent hip arthroscopy between November 2011 and December 2012. The International Hip Outcome Tool (iHOT-12) was the primary outcome at a minimum of 10-year follow-up. Radiographic progression of OA using Tönnis classification and conversion to THA were recorded. Statistical analysis of patient-reported outcome measures (PROMs) was performed with Wilcoxon signed-rank test. Relative risk assessment (RR) for conversion to THA for Tönnis grade 1 and 2 was reported.

Results

At 10-year follow-up, 26 patients (29 hips) had undergone THA, resulting in a hip survivorship of 59% while 41% of hips progressed to THA by 10 years. The mean time to THA was 7.1 years (±1.5). Patients with Tönnis grade 2 at baseline had a significantly higher risk of THA compared with Tönnis grade 1 (RR = 3.44, 95% CI: 1.81–6.55, p < 0.001). Among non-THA patients, 79% reported satisfaction with surgery. The iHOT-12 score improved from 41.4 (±17.1) preoperatively to 71.0 (±26.7) at follow-up (p < 0.001), with 67% of patients exceeding the minimal important change (MIC) threshold. Radiographic progression of Tönnis grade was observed in four hips.

Conclusion

Hip arthroscopy in patients with FAIS and mild to moderate OA provides substantial long-term functional benefits for those patients not having to undergo THA. However, preoperative OA severity is a key predictor of THA conversion with nearly two-fifths of hips requiring THA within 10 years.

Level of Evidence

Level IV, case series.

Abstract Image

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髋关节镜治疗股骨髋臼撞击合并骨关节炎的十年结果：持续的功能益处，但高度转化为全髋关节置换术。

目的：评价轻、中度骨关节炎（OA）患者行股髋臼撞击综合征（FAIS）髋关节镜治疗的长期临床和影像学结果。假设FAIS和轻度至中度OA患者在10年随访中会经历持续的iHOT-12改善，尽管OA自然进展。方法：这项前瞻性队列研究纳入了75例（80髋）患有FAIS和轻中度OA （Tönnis 1级或2级）的患者，这些患者在2011年11月至2012年12月期间接受了髋关节镜检查。国际髋关节结局工具（iHOT-12）是至少10年随访的主要结局。通过Tönnis分类和THA转换记录OA的影像学进展。采用Wilcoxon sign -rank检验对患者报告的预后指标（PROMs）进行统计分析。报告了Tönnis 1级和2级患者转化为THA的相对风险评估（RR）。结果：在10年随访中，26例患者（29髋）接受了髋关节置换术，髋关节存活率为59%，而41%的髋关节在10年内进展为髋关节置换术。平均THA时间为7.1年（±1.5年）。与Tönnis 1级患者相比，基线时Tönnis 2级患者发生THA的风险明显更高（RR = 3.44, 95% CI: 1.81-6.55, p）。结论：FAIS和轻度至中度OA患者的髋关节镜检查为那些无需进行THA的患者提供了实质性的长期功能益处。然而，术前OA严重程度是THA转换的关键预测因素，近五分之二的髋关节在10年内需要THA。证据等级：四级，案例系列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).