High Survival Rate and Satisfaction at more than 11 years of follow-up of Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Impact of Preoperative Functional Scores, Osteoarthritis, and Chondrolabral Junction Damage on Failure Long-Term 72.6% Survival in Hip Arthroscopy.

Purpose: The purpose of the study was to investigate the survival and durability of clinical improvements following hip arthoscopy (HA) for femoroacetabular impingement syndrome (FAIS) at a minimum of 10-year follow-up. The primary objective was to determine the long-term survival, defined as: lack of conversion to total hip replacement (THR) or subsequent hip joint preservation surgery (HJPS). The secondary objective was to determine which preoperative factors were predictive of failure.

Methods: Data from patients who underwent HA for FAIS between March 2003 and May 2012 were collected and retrospectively reviewed. Patients who underwent evaluation at a minimum 10-year follow-up, assessed according to hip outcome score - activities of daily living (HOS-ADL) and sport-specific subscale (HOS-SSS), and non-arthritic hip score (NAHS) were included. Satisfaction ratings were collected. Statistical analysis assessed within-group differences and survival.

Results: 95 patients with an average follow-up of 11.8 years were included. Mean age was 39.5 ± 11.0 years. Overall THR conversion rate was 24.2%, with a mean time of 3.4 ± 3.2 years. 3.2% required HJPS revision at a mean 3.2 ± 3 years. Survivorship was 72.6% at ten years. 28 patients (73.6% and 75.6%) achieved the minimal clinically important difference (MCID) for HOS-ADL and HOS-SSS, while 33 (84.6%) for NAHS. Patient Acceptable Symptom State (PASS) was achieved by 42 (61.7%), 43 (65.1%) and 44 (64.7%) patients respectively. Comparative analysis between patients who preserved their hip and those who underwent HJPS revision or THR highlighted that Tönnis ≥ 2, chondrolabral junction damage, and lower preoperative scores are associated with failure.

Conclusion: HA for FAIS demonstrated durable results, with an accepatable THR conversion rate and sustained clinical benefits. 91.3% of the patients who preserved their hip were satisfied. Tönnis 2, MRA signs of chondrolabral junction damage and lower preoperative functional status are strongly associated with failure.