Spencer Andrew D, Newby Nathan L, Nosrat Cameron, Wong Stephanie E, Zhang Alan L, Hagen Mia S
University of Washington School of Medicine, Seattle, Washington, USA.
University of California, San Francisco School of Medicine, San Francisco, California, USA.
Orthop J Sports Med. 2025 Jan 22;13(1):23259671241303766. doi: 10.1177/23259671241303766. eCollection 2025 Jan.
Femoroacetabular impingement syndrome (FAIS) is frequently treated arthroscopically with osteoplasty and labral repair. Surgical preferences vary in terms of equipment, technique, and postoperative protocol. Patient-reported outcome measures (PROMs) are valuable tools to assess outcomes across different institutions.
To compare PROMs after FAIS arthroscopy and evaluate the impact on postoperative outcomes with independent surgeons utilizing different surgical techniques and postoperative protocols.
Cohort study; Level of evidence, 2.
Prospective data were collected from patients with a 2-year follow-up after arthroscopic FAIS treatment by 2 orthopaedic surgeons from different states, each attending different sports medicine fellowships. Patients were matched according to age, sex, and body mass index. Data included patient characteristics, surgical findings, and the Hip disability and Osteoarthritis Outcome Score (HOOS) preoperatively and 2 years postoperatively. Patients with revision surgery, concomitant procedures, or incomplete pre- and postoperative data were excluded. Surgeon A utilized interportal capsulotomy, capsular repair, all-suture anchors, and a postoperative hip brace. Surgeon B employed periportal capsulotomy without repair, polyether ether ketone suture anchors, and no brace. The 2 high-volume arthroscopists (>100 hips/year) performed osteoplasty and labral repair and used a large perineal post. Cohorts were analyzed with appropriate tests, with significance set at < .05. The percentage of patients achieving minimal clinically important difference (MCID) was calculated using Pearson chi-square tests.
A total of 176 hips (100 women, 76 men) were included, with 88 matched patients from each institution. The mean age was 33.7 years and the body mass index was 26.3 kg/m. Both cohorts significantly improved in all 5 HOOS subscales 2 years after surgery. When comparing the mean change in PROMs and the percentage of patients achieving the MCID, differences were only observed in the HOOS-Sports subscale (cohort A: 25.3 ± 29.7 vs cohort B: 34.3 ± 29.7; = .048; MCID achieved in 57% of patients vs 76%; = .01).
This prospective cohort study on arthroscopic FAIS treatment indicates that matched patient cohorts from different institutions show similarly improved PROMs at 2 years. This study suggests consistent patient outcomes across sites despite geography, surgeon, training, surgical technique, implants, and postoperative protocol.
股骨髋臼撞击综合征（FAIS）通常通过关节镜下截骨术和盂唇修复术进行治疗。在设备、技术和术后方案方面，手术偏好各不相同。患者报告的结局指标（PROMs）是评估不同机构治疗效果的有价值工具。
比较FAIS关节镜检查后的PROMs，并评估不同手术技术和术后方案的独立外科医生对术后结局的影响。
队列研究；证据等级，2级。
前瞻性收集了来自不同州的2名骨科医生对FAIS进行关节镜治疗后随访2年的患者数据，每位医生参加不同的运动医学进修项目。根据年龄、性别和体重指数对患者进行匹配。数据包括患者特征、手术结果以及术前和术后2年的髋关节功能障碍和骨关节炎结局评分（HOOS）。排除接受翻修手术、同期手术或术前和术后数据不完整的患者。外科医生A采用经关节间囊切开术、关节囊修复、全缝合锚钉，并使用术后髋关节支具。外科医生B采用经关节周围囊切开术但不进行修复，使用聚醚醚酮缝合锚钉，不使用支具。这两位高年资关节镜外科医生（每年手术量>100例髋关节）进行截骨术和盂唇修复，并使用大型会阴柱。对队列进行适当的检验分析，显著性设定为P<0.05。使用Pearson卡方检验计算达到最小临床重要差异（MCID）的患者百分比。
共纳入176例髋关节（100例女性，76例男性），每个机构有88例匹配患者。平均年龄为33.7岁，体重指数为26.3kg/m²。两组患者术后2年所有5个HOOS子量表均有显著改善。在比较PROMs的平均变化和达到MCID的患者百分比时，仅在HOOS-运动子量表中观察到差异（队列A：25.3±29.7 vs队列B：34.3±29.7；P = 0.048；达到MCID的患者比例分别为57%和76%；P = 0.01）。
这项关于FAIS关节镜治疗的前瞻性队列研究表明，来自不同机构的匹配患者队列在2年时PROMs改善情况相似。这项研究表明，尽管地理位置、外科医生、培训、手术技术、植入物和术后方案不同，但各研究点的患者结局一致。
