Does Hip Arthroscopy Work? Results of 1000 Consecutive Labral Repairs for the Treatment of Femoro-acetabular Impingement (FAI)

Dunphy, O, Carton, P, Altuna, F

The Hip and Groin Clinic, Whitfield Clinic Medical Centre, Waterford.1-3

Introduction: Labral repair in conjunction with bony deformity correction has demonstrated superior results to labral debridement in the management of femoro-acetabular impingement. Limited publications are available on a large number of consecutive labral repairs for the treatment of femoro-acetabular impingement. One thousand consecutive labral repairs and early clinical outcome are presented.

Methodology: Patients who underwent arthroscopic bony deformity correction with labral repair for the treatment of pincer or mixed femoro-acetabular impingement over a six year period between September 2008 to June 2014, were assessed prospectively using internationally validated scoring systems preoperatively and postoperatively at a minimum of 1 year. Non-parametric data analysis was utilised to examine the significance of early clinical results. A p value of <0.05 was considered significant.

Results: In total, 1000 procedures were performed during this period (pre-op, n=987); 810 cases were male with average age of 30.5 (15.3– 72.7) years and 190 cases were female with average age of 37.8 (14.6 – 71.5) years. Highly significant improvement in all measures of postoperative outcome was observed at minimum 1 year (n=558) following surgery (p<0.005), with average follow-up of 17 months. The Harris Hip Score increased from a median preoperative score of 78 (IQR: 70 – 88) to a post operative score of 96 (87 – 100) at minimum 1 year; SF36 increased from 73 (60 – 85) to 91 (80 – 95); UCLA activity level increased from 6 (5 – 9) to 9 (7 – 10); WOMAC decreased from 18 (32 – 7) to 3 (11 – 0). 29 cases (2.9%) required conversion to a total hip replacement; 57 (5.7%) had repeat surgery; 76 (7.6%) had temporary mild numbness.

Conclusion: Labral repair in conjunction with bony deformity correction has shown to be an effective treatment for pincer or mixed femoro-acetabular impingement. Excellent post operative outcomes can be expected at minimum one year, with low complication rates.