Comparable Clinical Outcomes of Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Patients With Fibromyalgia: A Propensity-Matched Study With a Mean 2-Year Follow-Up.

PURPOSE

To evaluate patient-reported outcomes (PROs), achievement of clinically significant outcomes, and reoperation-free survivorship at short-term follow-up after hip arthroscopy (HA) for femoroacetabular impingement syndrome (FAIS) in patients with and without fibromyalgia (FM).

METHODS

A prospective repository was retrospectively reviewed to identify patients undergoing primary HA for FAIS between January 2012 and July 2019 with a 2-year follow-up. Exclusions included revisions, staged/concomitant procedures, congenital hip disorders, secondary hip pathology, or missing a 2-year follow-up. Patients with FM were propensity-matched 1:2, controlling for age, sex, and body mass index (BMI), with patients without FM. PROs included Hip Outcome Score-Activities of Daily Living and Hip Outcome Score-Sports Subscale, 12-item International Hip Outcome Tool, modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction. Cohort-specific minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds were calculated and compared. Reoperation rates were compared.

RESULTS

Overall, 33 hips in 30 patients with FM were matched to 66 hips in 66 patients without FM. Demographics were similar between those with FM (age: 37.03 ± 12.1 years; 93.9% female; BMI: 27.04 ± 6.7) and patients without FM (age: 38.85 ± 14.0 years; 92.4% female; BMI: 26.80 ± 5.5). Average follow-up was 26.6 months. At 2 years, patients with FM had inferior Hip Outcome Score-Sports Subscale (P = .01), mHHS (P = .009), 12-item International Hip Outcome Tool (P = .038), and VAS pain (P = .003) scores. However, achievement of MCID ≥1 PRO (P ≥ .999) and PASS ≥1 PRO (P = .15) at a 2-year follow-up was similar between groups. Patients with FM had inferior achievement of MCID for VAS pain and PASS for mHHS and VAS pain. Reoperation-free survivorship was comparable (P = .48).

CONCLUSIONS

Patients undergoing primary HA for FAIS with FM achieve statistically significant inferior PROs but show relatively comparable clinically significant outcomes to patients without FM at a 2-year follow-up, with the exception of mHHS for MCID and VAS pain for MCID and PASS. Patients with FM have similar reoperation-free survivorship compared to those without FM at a 2-year follow-up.

LEVEL OF EVIDENCE

Level III, retrospective, matched case-control study.