Predictors of Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement
Hip arthroscopy for femoroacetabular impingement (FAI) is a surgical procedure aimed at correcting the structural abnormalities of the hip joint that can cause pain and limited motion.
The benefits of hip arthroscopy for FAI have been well established. However, the outcomes of this procedure can vary, and several factors have been identified as potential predictors. These include:
- Age: Younger patients often have better outcomes due to higher potential for recovery and less advanced joint degeneration.
- Sex: Some studies report that males have better outcomes than females. Others found female se to be a positive predictor.
- Body Mass Index (BMI): Higher BMI can be associated with poorer outcomes, possibly due to increased stress on the joint and surgical complications.
- Preoperative Intra-articular hip injections: Greater reductions in pain with preoperative intra-articular anesthetic injections were found to be associated to better outcomes after FAI surgery, but all available studies contain a high risk of bias.
- Severity and Duration of Symptoms: Patients with severe or long-standing symptoms might have more advanced joint damage, potentially leading to less favorable outcomes. Patients with chronic pain predicts inferior outcomes from hip arthroscopy for FAI. Patients with back pain negatively influence outcomes.
- Athletes: Athletes undergoing hip arthroscopy for FAI, predict significant improvement and a high rate of return to sport at the same or greater competition level when compared to preinjury level.
- Presence of Osteoarthritis: The presence and degree of osteoarthritis in the hip can negatively impact the outcomes of the surgery.
- Presence of Hip Dysplasia: The presence of hip dysplasia can impact outcomes depending on the severity of the dysplasia. Studies report that patients with borderline hip dysplasia can acheive significant improvement.
- Hip Joint Morphology: Specific structural characteristics of the hip joint, as identified through imaging studies, can influence surgical outcomes.
- Extent of Surgical Correction: The amount and type of bone and soft tissue correction performed can impact outcomes.
- Surgical Technique and Experience of Surgeon: The expertise of the surgeon and the specific techniques used can influence the success of the procedure.
- Rehabilitation and Physical Therapy Compliance: Effective and consistent postoperative rehabilitation is crucial for successful recovery.
- Patient’s General Health and Comorbidities: Overall health status and the presence of other medical conditions can affect recovery.
- Patient Expectations and Mental Health: A patient’s expectations and mental well-being can play a significant role in their perception of the surgery’s success and their postoperative recovery.
It’s important to note that the relationship between these factors and surgical outcomes can be complex. They often interact with each other, and their individual impact can vary from patient to patient. Regular follow-up and personalized management strategies are essential for optimizing outcomes in patients undergoing hip arthroscopy for FAI.
When you or a loved one is suffering FAI, surgical expertise and experience matters greatly. If you have hip pain it is important to get the correct diagnosis right away. The team at LALL Orthopedics + can help establish the cause of your hip pain and review all available non-surgical and surgical treatment options. We have multiple offices locations conveniently located in New Jersey, Manhattan, Philadelphia and West Palm Beach, FL.
References
- Martins EC, Gomes DA, de Brito Fontana H, Fernandes DA. Does response to preoperative intra-articular anesthetic injections predict outcomes of femoroacetabular impingement syndrome? Arch Orthop Trauma Surg. 2023 Oct;143(10):6283-6294. doi: 10.1007/s00402-023-04927-6. Epub 2023 Jun 14. PMID: 37316693.
- McCormack TJ, Vopat ML, Rooker J, Tarakemeh A, Baker J, Templeton KJ, Mulcahey MK, Mullen SM, Schroeppel JP, Vopat BG. Sex-Based Differences in Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review. Orthop J Sports Med. 2022 Nov 25;10(11):23259671221137857. doi: 10.1177/23259671221137857. PMID: 36452337; PMCID: PMC9703514.
- Annin S, Lall AC, Yelton MJ, Shapira J, Rosinsky PJ, Meghpara MB, Maldonado DR, Ankem H, Domb BG. Patient-Reported Outcomes in Athletes Following Hip Arthroscopy for Femoroacetabular Impingement With Subanalysis on Return to Sport and Performance Level: A Systematic Review. Arthroscopy. 2021 Aug;37(8):2657-2676. doi: 10.1016/j.arthro.2021.03.064. Epub 2021 Apr 19. PMID: 33887407.
- Chen SL, Maldonado DR, Go CC, Kyin C, Lall AC, Domb BG. Outcomes of Hip Arthroscopic Surgery in Adolescents With a Subanalysis on Return to Sport: A Systematic Review. Am J Sports Med. PMID: 31539278
- Sogbein OA, Shah A, Kay J, Memon M, Simunovic N, Belzile EL, Ayeni OR. Predictors of Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review. Orthop J Sports Med. 2019 Jun 19;7(6):2325967119848982. doi: 10.1177/2325967119848982. PMID: 31259183; PMCID: PMC6585257.
- Beck EC, Nwachukwu BU, Chahla J, Jan K, Keating TC, Suppauksorn S, Nho SJ. Patients With Borderline Hip Dysplasia Achieve Clinically Significant Outcome After Arthroscopic Femoroacetabular Impingement Surgery: A Case-Control Study With Minimum 2-Year Follow-up. Am J Sports Med. 2019 Sep;47(11):2636-2645. doi: 10.1177/0363546519865919. Epub 2019 Aug 16. PMID: 31419157.
- https://pubmed.ncbi.nlm.nih.gov/33151746/
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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