PMID- 38164672 OWN - NLM STAT- MEDLINE DCOM- 20240103 LR - 20240213 IS - 1552-3365 (Electronic) IS - 0363-5465 (Linking) VI - 52 IP - 1 DP - 2024 Jan TI - Functional Outcome Scores and Conversion to Total Hip Arthroplasty After Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Patients With Tonnis Grade 1 Versus Grade 0 Arthritis: A Propensity-Matched Study at Minimum 10-Year Follow-up. PG - 34-44 LID - 10.1177/03635465231210958 [doi] AB - BACKGROUND: Hip arthroscopy has become the mainstay surgical intervention for the treatment of femoroacetabular impingement syndrome (FAIS). However, postoperative outcomes and rates of secondary surgery are mixed in patients with differing levels of preoperative osteoarthritis (OA). Furthermore, there is a paucity of literature comparing patients with and without OA at long-term follow-up. PURPOSE: To compare outcomes and rates of secondary surgery at minimum 10-year follow-up, including revision hip arthroscopy and conversion to total hip arthroplasty (THA), in patients with Tonnis grade 1 undergoing hip arthroscopy for FAIS compared with a propensity-matched control group of patients with Tonnis grade 0. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients who underwent primary hip arthroscopy for FAIS between January 2012 and February 2013 were identified. Patients with Tonnis grade 1 were propensity matched in a 1:2 ratio by age, sex, and body mass index (BMI) to patients with Tonnis grade 0. Patient-reported outcomes (PROs) were collected at varying timepoints including preoperatively and 1, 2, 5, and 10 years postoperatively and compared between the 2 cohorts. Rates of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) achievement at 10 years were evaluated and compared between groups. Rates of secondary surgery including revision hip arthroscopy and conversion to total hip arthroplasty (THA) were evaluated. Gross survivorship between cohorts was evaluated using a Kaplan-Meier gross survivorship curve. A subanalysis was performed comparing patients with Tonnis grade 1 who converted to THA and those who did not. RESULTS: A total of 31 patients with Tonnis grade 1 (age, 42.6 +/- 9.0 years; BMI, 28.0 +/- 6.3) were successfully matched to 62 patients with Tonnis grade 0 (age, 42.1 +/- 8.5, P = .805; BMI, 26.1 +/- 3.9, P = .117). Both the Tonnis grade 1 and Tonnis grade 0 groups demonstrated significant improvements regarding all PROs at minimum 10 years (P < .05 for all), except for the Hip Outcome Score Activities of Daily Living subscale (HOS-ADL) (P = .066) in the Tonnis grade 1 cohort. No significant difference (P > .05 for all) was noted between cohorts regarding any 10-year PRO. When the authors evaluated comparisons between preoperative and 1-, 2-, 5-, and 10-year PRO measures, significant differences were noted between cohorts regarding 2-year HOS-ADL (P = .021), Hip Outcome Score Sports-Specific subscale (P = .016), and modified Harris Hip Score (P = .026); otherwise, differences did not reach significance. High rates of 10-year MCID and PASS achievement were seen, with no significant differences between groups. Patients with Tonnis grade 1 had significantly higher rates of conversion to THA compared with patients who had Tonnis grade 0 (25.8% vs 4.8%; P = .006). Patients with Tonnis grade 1 had significantly lower gross survivorship compared with those who had Tonnis grade 0 (71.0% vs 85.5%, respectively; P = .04). CONCLUSION: Hip arthroscopy confers comparable postoperative clinical improvements to patients who have FAIS with and without mild OA; however, the benefits among patients with mild OA may be less durable. Patients with Tonnis grade 1 had significantly higher conversion to THA and reduced gross survivorship compared with patients with no evidence of preoperative OA, suggesting that patients with evidence of OA may need to be cautioned on the higher rate of conversion surgery. FAU - Fenn, Thomas W AU - Fenn TW AD - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. FAU - Kaplan, Daniel J AU - Kaplan DJ AD - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. AD - Department of Orthopaedic Surgery, Division of Sports Medicine, NYU Langone Orthopaedic Hospital, New York, New York, USA. FAU - Brusalis, Christopher M AU - Brusalis CM AD - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. AD - Department of Orthopaedic Surgery, Division of Sports Medicine, Hospital for Special Surgery, New York, New York, USA. FAU - Chapman, Reagan S AU - Chapman RS AD - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. FAU - Larson, Jordan H AU - Larson JH AD - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. FAU - Nho, Shane J AU - Nho SJ AD - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush Medical College of Rush University, Rush University Medical Center, Chicago, Illinois, USA. LA - eng PT - Journal Article PL - United States TA - Am J Sports Med JT - The American journal of sports medicine JID - 7609541 SB - IM MH - Humans MH - Adult MH - Middle Aged MH - *Femoracetabular Impingement/surgery MH - *Arthroplasty, Replacement, Hip MH - Hip Joint/surgery MH - Follow-Up Studies MH - Cohort Studies MH - Treatment Outcome MH - Arthroscopy MH - Activities of Daily Living MH - *Osteoarthritis/surgery MH - Patient Reported Outcome Measures MH - Retrospective Studies OTO - NOTNLM OT - Tonnis grade OT - femoroacetabular impingement OT - hip arthroscopy OT - long-term outcomes OT - osteoarthritis COIS- One or more of the authors has declared the following potential conflict of interest or source of funding: C.M.B. has received support for education from Smith + Nephew. S.J.N. has received research support from Allosource, Arthrex, Athletico, DJ Orthopedics, Linvatec, Miomed, and Smith + Nephew; consulting fees and royalties from Ossur, Springer, and Stryker; and support for education from Elite Orthopaedics. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. EDAT- 2024/01/02 11:46 MHDA- 2024/01/03 09:42 CRDT- 2024/01/02 04:13 PHST- 2024/01/03 09:42 [medline] PHST- 2024/01/02 11:46 [pubmed] PHST- 2024/01/02 04:13 [entrez] AID - 10.1177/03635465231210958 [doi] PST - ppublish SO - Am J Sports Med. 2024 Jan;52(1):34-44. doi: 10.1177/03635465231210958.