Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, USA.
Division of Sports Medicine, Department of Orthopedic Surgery, Houston Methodist, Houston, Texas, USA.
Am J Sports Med. 2024 Jan;52(1):24-33. doi: 10.1177/03635465231212663.
Hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) has proven to be an effective surgical intervention, with high rates of return to sport and work as well as favorable outcomes at short- and midterm follow-up. However, limited data exist on outcomes at long-term follow-up.
To evaluate patient-reported outcomes (PROs) at a minimum 10-year follow-up after primary hip arthroscopic surgery including labral repair, femoral osteochondroplasty, acetabular osteochondroplasty, and capsular closure for FAIS.
Case series; Level of evidence, 4.
Patients who underwent primary hip arthroscopic surgery for FAIS between June 2012 and January 2013 were identified. PROs were collected preoperatively and at a minimum of 10 years postoperatively, including the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), International Hip Outcome Tool-12 (iHOT-12), and visual analog scale (VAS) for pain and satisfaction. Unique minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds were calculated, and their rates of achievement were analyzed. An alpha level of <.05 was used to determine statistical significance.
A total of 94 patients (55 female; mean age, 34.3 ± 12.4 years) were analyzed with a mean follow-up of 10.1 ± 0.3 years (range, 10.0-10.7 years). Patients demonstrated significant 10-year improvement across all PRO measures ( < .001). MCID and PASS thresholds were calculated as follows: HOS-ADL (10.4 and 85.3, respectively), HOS-SS (14.6 and 60.2, respectively), mHHS (8.8 and 76.0, respectively), VAS pain (14.6 and 27.5, respectively), and iHOT-12 (PASS: 71.4). The majority of patients achieved the MCID and PASS for each PRO measure: HOS-ADL (73.4% and 70.9%, respectively), HOS-SS (78.5% and 77.2%, respectively), mHHS (81.0% and 70.9%, respectively), VAS pain (88.6% and 70.9%, respectively), and iHOT-12 (PASS: 73.4%). Overall, 9 patients (9.6%) underwent subsequent revision hip arthroscopic surgery at a mean 4.9 ± 3.7 years (range, 1.1-10.1 years) postoperatively, and 6 patients (6.4%) underwent conversion to total hip arthroplasty at a mean 4.1 ± 3.1 years (range, 0.9-9.3 years) postoperatively.
Patients who underwent primary hip arthroscopic surgery for FAIS utilizing contemporary methods of labral repair, acetabular and/or femoral osteochondroplasty, and capsular closure commonly experienced sustained clinical improvement and reported high levels of satisfaction at a minimum 10-year follow-up with low rates of reoperation.
髋关节镜手术治疗股骨髋臼撞击综合征（FAIS）已被证明是一种有效的手术干预措施，具有较高的重返运动和工作的比率，以及在短期和中期随访中良好的结果。然而，关于长期随访的结果数据有限。
评估 FAIS 患者在初次髋关节镜手术后至少 10 年的患者报告结局（PRO），包括盂唇修复、股骨骨软骨成形术、髋臼骨软骨成形术和囊闭合并用于 FAIS。
病例系列；证据水平，4 级。
确定了 2012 年 6 月至 2013 年 1 月期间接受 FAIS 初次髋关节镜手术的患者。在术前和至少 10 年后收集 PRO，包括髋关节结果评分-日常生活活动（HOS-ADL）、髋关节结果评分-运动亚量表（HOS-SS）、改良 Harris 髋关节评分（mHHS）、国际髋关节结局工具-12（iHOT-12）和疼痛及满意度的视觉模拟量表（VAS）。计算了独特的最小临床重要差异（MCID）和可接受的患者症状状态（PASS）阈值，并分析了其达到率。采用<.05 的 α 水平来确定统计学意义。
共分析了 94 例患者（55 例女性；平均年龄，34.3±12.4 岁），平均随访 10.1±0.3 年（范围，10.0-10.7 年）。所有 PRO 测量均显示出 10 年的显著改善（<.001）。计算了 MCID 和 PASS 阈值如下：HOS-ADL（分别为 10.4 和 85.3）、HOS-SS（分别为 14.6 和 60.2）、mHHS（分别为 8.8 和 76.0）、VAS 疼痛（分别为 14.6 和 27.5）和 iHOT-12（PASS：71.4）。大多数患者达到了每个 PRO 测量的 MCID 和 PASS：HOS-ADL（分别为 73.4%和 70.9%）、HOS-SS（分别为 78.5%和 77.2%）、mHHS（分别为 81.0%和 70.9%）、VAS 疼痛（分别为 88.6%和 70.9%）和 iHOT-12（PASS：73.4%）。总体而言，9 例（9.6%）患者在术后平均 4.9±3.7 年（范围，1.1-10.1 年）后再次接受髋关节镜手术翻修，6 例（6.4%）患者在术后平均 4.1±3.1 年（范围，0.9-9.3 年）后转为全髋关节置换术。
采用现代盂唇修复、髋臼和/或股骨骨软骨成形术以及囊闭合并用于 FAIS 的初次髋关节镜手术患者，通常在至少 10 年的随访中持续获得临床改善，并报告高满意度，再手术率较低。
