PMID- 37207920
OWN - NLM
STAT- MEDLINE
DCOM- 20230705
LR  - 20230705
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 39
IP  - 8
DP  - 2023 Aug
TI  - Patients Maintain Clinically Significant Outcomes at 5-Year Follow-Up After Hip 
      Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review.
PG  - 1869-1881.e1
LID - S0749-8063(23)00388-2 [pii]
LID - 10.1016/j.arthro.2023.04.021 [doi]
AB  - PURPOSE: To assess 5-year outcomes and survival rate of hip arthroscopy (HA) for 
      femoroacetabular impingement syndrome (FAIS) and to determine achievement rates 
      of clinically significant outcomes. METHODS: Three databases were searched around 
      the following terms: hip arthroscopy, FAIS, and 5-year follow-up. Articles 
      available in English, presenting original data, and reporting minimum 5-year 
      follow-up after primary HA using either patient-reported outcomes (PROs) or 
      conversion to total hip arthroplasty (THA) and/or revision surgery were included. 
      Quality assessment was completed using MINORS assessment, and relative agreement 
      was calculated using Cohen's kappa. RESULTS: Fifteen articles were included. 
      MINORS assessment ranged from 11 to 22, with excellent (k = 0.842) inter-rater 
      reliability between reviewers. 2,080 patients were included at a follow-up range 
      of 60.0-84 months. Labral repair was the most commonly performed procedure 
      (range: 8.0%-100%). All studies included PROs, and all reported statistically 
      significant improvement (P < .05) at the 5-year timepoint. The most frequent PRO 
      was modified Harris Hip Score (mHHS) (n = 8). Nine studies reported on clinically 
      significant outcome achievement, with mHHS being the most common (n = 8). The 
      rate of achieving minimal clinically important difference (MCID) ranged from 64 
      to 100%, patient-acceptable symptomatic state (PASS) ranged from 45 to 87.4%, and 
      substantial clinical benefit (SCB) ranged from 35.3 to 66%. Conversion to THA and 
      revision surgery varied across studies, with ranges of 0.0%-17.9% (duration: 
      28.8-87.1 months) and 1.3%-26.7% (duration: 14.8-83.7 months), respectively. The 
      most common definition of failure was conversion to THA or revision (n = 7). 
      Increased age (n = 5) and greater joint degeneration (n = 4) were the most common 
      predictors of clinical failure. CONCLUSIONS: Patients undergoing primary hip 
      arthroscopy for FAIS demonstrated significant improvement at 5-year follow-up, 
      with maintained rates of achievement of MCID, PASS, and SCB. Survival rate of HA 
      at 5 years is overall high, with ranges of 0.0-17.9% and 1.3-26.7% conversion to 
      THA or revision surgery, respectively. Across studies, increased age and greater 
      joint degeneration were the most commonly cited predictors of clinical failure. 
      LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.
CI  - Copyright (c) 2023 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Jan, Kyleen
AU  - Jan K
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Fenn, Thomas W
AU  - Fenn TW
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.. Electronic address: 
      nho.research@rushortho.com.
FAU - Kaplan, Daniel J
AU  - Kaplan DJ
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
FAU - Nho, Shane J
AU  - Nho SJ
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois, U.S.A.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20230518
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
MH  - Humans
MH  - *Femoracetabular Impingement/surgery
MH  - Follow-Up Studies
MH  - Treatment Outcome
MH  - Arthroscopy/methods
MH  - Reproducibility of Results
MH  - Activities of Daily Living
MH  - Patient Reported Outcome Measures
MH  - *Osteoarthritis
MH  - Hip Joint/surgery
MH  - Retrospective Studies
EDAT- 2023/05/20 09:42
MHDA- 2023/07/05 06:42
CRDT- 2023/05/19 19:26
PHST- 2023/01/04 00:00 [received]
PHST- 2023/04/26 00:00 [revised]
PHST- 2023/04/27 00:00 [accepted]
PHST- 2023/07/05 06:42 [medline]
PHST- 2023/05/20 09:42 [pubmed]
PHST- 2023/05/19 19:26 [entrez]
AID - S0749-8063(23)00388-2 [pii]
AID - 10.1016/j.arthro.2023.04.021 [doi]
PST - ppublish
SO  - Arthroscopy. 2023 Aug;39(8):1869-1881.e1. doi: 10.1016/j.arthro.2023.04.021. Epub 
      2023 May 18.