Gender and Age-Specific Differences Observed in Rates of Achieving Meaningful Clinical Outcomes 5-Years After Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Arthroscopy. 2021 Aug;37(8):2488-2496.e1. doi: 10.1016/j.arthro.2021.02.033. Epub 2021 Mar 5.

Abstract

Purpose: To compare the impact of age and gender on achieving meaningful outcomes among minimum patients 5 years after undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Methods: Consecutive patients undergoing hip arthroscopy for FAIS by a single fellowship-trained surgeon between January 2012 and October 2014 were analyzed. Study inclusion criteria included any patient undergoing primary hip arthroscopy for FAIS, with 5 years follow-up. Preoperative and 5-year postoperative functional scores were collected, including the Hip Outcome Score Activities of Daily Living Subscale (HOS-ADL), HOS-Sport Subscale (HOS-SS), modified Harris hip score (mHHS), and Visual Analog Scale for satisfaction. Patients were matched 1:1 by gender and age to compare outcomes between these 2 demographics. Minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were calculated for each functional measure and compared by gender and age.

Results: Of the 340 patients (70.5%) with 5 years' follow up, 150 were matched by gender and age into one of the following groups: female patients <30 years, female patients 30 to 45 years, female patients >45 years, male patients <30 years, male patients 30 to 45 years, and male patients >45 years of age. At minimum 5-year follow-up, all 6 groups demonstrated statistically significant improvement in the functional outcome score averages and pain (P < .001 for all). Both within gender and within age category analysis of postoperative functional scores did not demonstrate any statistical differences (P > .05). Analysis of achieving MCID and PASS demonstrated that females had higher rates of reaching the HOS-SS and mHHS threshold for achieving MCID as compared to their male counterparts (P < .05). Furthermore, patients <30 years old had higher rates of reaching the HOS-ADL and mHHS for achieving PASS when compared to patients >45 years old (P < .05).

Conclusion: The majority of patients achieve clinically significant outcome improvement at 5-year follow-up after arthroscopic FAIS surgery. Females reach the mHHS threshold for achieving MCID at significantly higher rates than males. Patients <30 years of age achieved PASS on the HOS-ADL and mHHS threshold scores at higher rates than those >45 years old.

Level of evidence: Level III, case-control study.

MeSH terms

  • Activities of Daily Living
  • Adult
  • Age Factors
  • Arthroscopy
  • Case-Control Studies
  • Female
  • Femoracetabular Impingement* / surgery
  • Follow-Up Studies
  • Hip Joint / surgery
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Retrospective Studies
  • Treatment Outcome