Berzolla Emily, Esser Katherine L, Gosnell Griffith G, Mercer Nathaniel, Kaplan Daniel J, Youm Thomas
NYU Langone Orthopedic Center, Department of Orthopedic Surgery, New York, NY, USA.
Am J Sports Med. 2025 Jul;53(8):1841-1848. doi: 10.1177/03635465251342119. Epub 2025 May 30.
While both short- and long-term outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) have been reported, the predictive relationship between the two has yet to be established.
To determine whether the degree of improvement in patient-reported outcomes observed at 1 year postoperatively predicts long-term outcomes at 10 years after primary hip arthroscopy for FAIS.
Cohort study; Level of evidence, 3Methods:Patients who underwent primary hip arthroscopy for FAIS by a single surgeon at a single institution with 10-year follow-up were identified. Outcomes were assessed using the modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) at baseline and 1, 2, 5, and 10 years postoperatively. Patients were classified as either high improvement (HI) or low improvement (LI) based on if they achieved the median 1-year change in mHHS from baseline. Chart review was performed to collect surgical details such as operative procedures, complications, and revision surgery. Outcomes were compared between groups over time using repeated-measures analysis of variance. Failure rates were determined using Kaplan-Meier and Mantel-Cox log-rank analyses.
A total of 129 patients with a mean age of 41.0 ± 13.5 years and mean body mass index of 25.0 ± 4.3 kg/m were included. Both the HI and LI groups demonstrated significant improvement in mHHS and NAHS from baseline at all follow-up time points ( < .001). The HI group had significantly higher outcome scores at all time points up to 10 years after arthroscopy compared with the LI group ( = .018). Additionally, a greater proportion of patients in the HI group achieved the Patient Acceptable Symptom State and minimal clinically important difference compared with the LI group at the 10-year follow-up ( = .018). Rates of overall complications, revision arthroscopy, and conversion to total hip arthroscopy were significantly higher in the LI group ( = .013, = .009, and = .004, respectively). The mean hip survival time after the index operation was shorter for the LI group (11.9 ± 0.5 years) than for the HI group (13.2 ± 0.2 years) ( = .002).
Patients who experienced greater improvement in the first year after hip arthroscopy had superior 10-year outcome scores, fewer complications, and lower rates of reoperation compared with those who experienced minimal improvement in the same period.
虽然已有关于股骨髋臼撞击综合征（FAIS）髋关节镜检查术后短期和长期结果的报道，但两者之间的预测关系尚未确立。
确定FAIS初次髋关节镜检查术后1年观察到的患者报告结局改善程度是否能预测10年的长期结局。
队列研究；证据水平，3
确定在单一机构由单一外科医生对FAIS进行初次髋关节镜检查并随访10年的患者。在基线以及术后1、2、5和10年使用改良Harris髋关节评分（mHHS）和非关节炎髋关节评分（NAHS）评估结局。根据患者从基线起mHHS的1年变化是否达到中位数，将患者分为高改善组（HI）或低改善组（LI）。进行病历审查以收集手术细节，如手术操作、并发症和翻修手术。使用重复测量方差分析比较两组随时间的结局。使用Kaplan-Meier和Mantel-Cox对数秩分析确定失败率。
共纳入129例患者，平均年龄41.0±13.5岁，平均体重指数25.0±4.3kg/m。HI组和LI组在所有随访时间点的mHHS和NAHS均较基线有显著改善（P<.001）。与LI组相比，HI组在关节镜检查后长达10年的所有时间点的结局评分均显著更高（P=.018）。此外，在10年随访时，HI组达到患者可接受症状状态和最小临床重要差异的患者比例高于LI组（P=.018）。LI组的总体并发症、翻修关节镜检查和转为全髋关节置换术的发生率显著更高（分别为P=.013、P=.009和P=.004）。LI组初次手术后的平均髋关节生存时间（11.9±0.5年）短于HI组（13.2±0.2年）（P=.002）。
与同期改善最小的患者相比，髋关节镜检查后第一年改善较大的患者10年结局评分更高，并发症更少，再次手术率更低。
