Outcomes of Hip Arthroscopy for Femoroacetabular Impingement in Chinese Patients Aged 50 Years or Older

Objective: To investigate the outcomes of hip arthroscopy for femoroacetabular impingement (FAI) in patients over the age of 50 years.

Method: This is a therapeutic case series study. A total of 27 FAI patients over the age of 50 years who met inclusion and exclusion criteria and were being followed up for at least 2 years in the orthopaedics department at our hospital between January 2015 and October 2017 were recruited for a prospective analysis on the outcomes of hip arthroscopy. All patients underwent unilateral surgery. Of the patients included, there were 15 men and 12 women, who were aged 50-74 years old (57 ± 6.4 years). The outcomes were assessed using the visual analog scale (VAS), the modified Harris hip score (mHHS), and the International Hip Outcome Tool (iHOT-12).

Results: A total of 27 patients were followed up for at least 2 years. The postoperative center-edge angle, the alpha angle, and the offset decreased significantly compared with preoperative measurements (P < 0.01). The mHHS before surgery and at 1 year and 2 years after surgery was 62.19 ± 7.47, 86.70 ± 5.80, and 87.89 ± 5.08, respectively; iHOT-12 scores were 30.44 ± 4.22, 73.56 ± 3.89, and 73.77 ± 3.72, respectively; VAS scores were 6.07 ± 0.78, 1.93 ± 0.73, and 1.59 ± 0.64, respectively. As compared with the condition before surgery, there was a significant improvement in the mHHS, iHOT-12, and VAS scores at 1 year and 2 years after surgery (P < 0.01). The mHHS score at 2-year follow up after surgery was higher than that at 1 year after surgery, and the difference observed was statistically significant (P = 0.04). One patient with severe acetabular and femoral cartilage damage underwent total hip replacement 11 months after surgery.

Conclusion: Hip arthroscopy considerably improved hip symptoms and function in Chinese FAI patients aged 50 years or older who did not have severe radiographic osteoarthritis. The conversion to THA and complications were low. Strict surgical indications and appropriate surgical strategies lay the foundation for satisfactory postoperative results in elderly patients with FAI.

Keywords: Elder patient; Femoroacetabular impingement; Hip arthroscopy; Outcomes.