Treatment of Labral Calcification in the Setting of Femoroacetabular Impingement Syndrome with Arthroscopic Calcification Excision, Labral Repair and Osteoplasty Improves Outcomes

Purpose: To describe the diagnosis and 2-year outcomes of arthroscopic treatment for labral calcification in the setting of femoroacetabular impingement syndrome (FAIS).

Methods: A retrospective analysis was performed from a prospectively collected database of FAIS patients undergoing hip arthroscopy. FAIS patients with labral calcification were differentiated radiographically from patients with other paralabral radiopaque densities (ROD) such as os acetabuli, acetabular rim fractures and labral ossification. FAIS patients with labral calcification were treated with arthroscopic calcification excision, labral repair and osteoplasty and matched by age, sex and BMI with a cohort of FAIS patients without labral calcifications who underwent labral repair and osteoplasty. Pre- and 2 years post-operatively, patients completed patient reported outcomes (PRO) scores including the modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form survey (SF-12) and visual analog scale (VAS).

Results: 40 hips (21 male, 19 female) with FAIS and labral calcification were included (age 36.8 ± 8.1, BMI, 25.9 ± 4.5). FAIS patients with labral calcification demonstrated similar significant PRO score improvements compared to a matched cohort of FAIS patients without labral calcification at 2 years after surgery (VAS- (-)2.3 ± 0.4, (-)2.7 ± 0.5, mHHS- 16.1 ± 2.6, 17.1 ± 3.2; HOOS symptoms- 21.9 ± 3.7, 18.6 ± 3.6; HOOS pain- 22.1 ± 3.0, 25.0 ± 3.5; HOOS activities of daily living- 20.2 ± 2.8, 23.8 ± 3.3; HOOS sport- 35.6 ± 5.0, 35.6 ± 4.1; HOOS quality of life- 36.9 ± 4.5, 37.5 ± 4.4; SF-12 physical component summary- 15.5 ± 2.3, 20.1 ± 2.1, respectively). Both cohorts achieved minimal clinically important differences (MCID) at equivalent rates (60-82.5%) for all PRO scores.

Conclusions: Patients with labral calcification in the setting of FAIS can be effectively treated with arthroscopic calcification excision, labral repair and osteoplasty. These patients demonstrate significant improvements in patient reported outcomes and achievement of MCID at 2 years similar to patients undergoing arthroscopic treatment for FAIS without labral calcification.

Keywords: femoroacetabular impingement; hip arthroscopy; labral calcification; os acetabuli; patient outcomes.