Timing From Symptom Onset to Hip Arthroscopy Does Not Affect Patient-Reported Outcome Measures for the Treatment of Femoroacetabular Impingement in Adolescent Patients

Joseph J Ruzbarsky; Spencer M Comfort; Naomasa Fukase; Karen K Briggs; Leslie B Vidal; Marc J Philippon

doi:10.1016/j.arthro.2023.03.028

Timing From Symptom Onset to Hip Arthroscopy Does Not Affect Patient-Reported Outcome Measures for the Treatment of Femoroacetabular Impingement in Adolescent Patients

Arthroscopy. 2023 Dec;39(12):2466-2473. doi: 10.1016/j.arthro.2023.03.028. Epub 2023 Apr 24.

Authors

Joseph J Ruzbarsky¹, Spencer M Comfort², Naomasa Fukase², Karen K Briggs², Leslie B Vidal¹, Marc J Philippon³

Affiliations

¹ Steadman Philippon Research Institute, Vail, Colorado, U.S.A; Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport, Vail, Colorado, U.S.A.
² Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
³ Steadman Philippon Research Institute, Vail, Colorado, U.S.A; Steadman Clinic and United States Coalition for the Prevention of Illness and Injury in Sport, Vail, Colorado, U.S.A. Electronic address: drphilippon@sprivail.org.

PMID: 37100216
DOI: 10.1016/j.arthro.2023.03.028

Abstract

Purpose: To evaluate symptom duration and its relationship to patient-reported outcomes (PROs) and survivorship after hip arthroscopy in adolescents.

Methods: Patients ≤18 at time of primary hip arthroscopy for femoroacetabular impingement (FAI) between January 2011 and September 2018 were included. Exclusion criteria consisted of history of previous ipsilateral hip surgery, presence of osteoarthritis or dysplasia on preoperative radiographs, previous hip fracture, or history of slipped capital femoral epiphysis or Legg-Calve-Perthes disease. Minimum 2-year PROs (modified Harris Hip Score, Hip Outcome Score [HOS]-Activities of Daily Living, HOS-Sport Scale, Short Forms 12 [SF-12]), minimum clinically significant difference (MCID) and patient-acceptable symptom state (PASS) rates, and revision surgery rates were compared based on symptom duration.

Results: Two-year minimal follow-up was obtained for 111 patients (134 hips) (80%), including 74 females and 37 males with a mean age of 16.4 ± 1.1 (range 13.0-18.0). The mean symptom duration was 17.2 ± 15.2 months (range 43 days to 6.0 years). Ten patients (11 hips), 6 females (7 hips) and 4 males, required revision surgery at an average of 2.3 ± 1.0 years (range 0.9-4.3 years). At a mean follow-up of 4.8 ± 2.2 years (range 2-10 years), there were statistically significant improvements in all PROs (P < .05 for all). Symptom duration showed no significant correlation to post-operative scores (correlation coefficient range -0.162 to -0.078, P > .05 for all). Symptom duration ≤12 months versus >12 months or as a continuous variable was not a predictor for requiring revision surgery or achieving MCID/PASS (95% confidence interval crosses 1 for all).

Conclusions: In an adolescent cohort of symptomatic FAI patients who underwent hip arthroscopy, there is no difference in PRO measures when analyzing symptom duration by arbitrary time intervals or as a continuous variable.

Level of evidence: Level IV, case series.

MeSH terms

Activities of Daily Living
Adolescent
Arthroscopy
Female
Femoracetabular Impingement* / surgery
Hip Fractures*
Humans
Male
Patient Reported Outcome Measures