Background:Arthroscopic treatment of femoroacetabular impingement has increased in popularity since the early 2000s when it was first described, although only a few midterm follow-up studies have been published.Purpose:To describe the outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement at a mean 12-year follow-up and to determine the risk factors for failure.Study Design:Case-control study; Level of evidence, 3.Methods:The Non-Arthritic Hip Score (NAHS) and a radiographic evaluation were completed preoperatively and at midterm follow-up. Participants were divided into 2 groups according to their clinical evolution. The success group consisted of patients whose NAHS at the final follow-up was above the established Patient Acceptable Symptom State (PASS) threshold of 81.9, whereas patients who underwent a second surgical intervention or did not reach the PASS threshold at final follow-up were assigned to the failure group. These groups were compared to identify preoperative differences in demographic, pathological, and surgical factors.Results:A total of 95 hips were included, after 23 were lost to follow-up (80.5% follow-up). At a mean follow-up of 12.1 years (range, 9.2-16.0 years), 9 hips required total hip arthroplasty (9.5%), 5 required revision hip arthroscopy (5.3%), 29 did not achieve the NAHS PASS threshold (30.5%), and 52 achieved the NAHS PASS threshold (54.7%). The mean NAHS was 82.4 at final follow-up compared with 66.9 preoperatively (mean difference = 15.5; P < .001). Higher mean body mass index (24.9 vs 23.0; P = .030), older age (30.0 vs 27.2; P = .035), and inferior preoperative lateral joint space width (3.9 vs 4.4; P = .019) were associated with inferior prognosis in the failure group versus success group. Osteoarthritis progression was observed in 69.2% of the failure group and in 34.8% of the success group ( P = .082). Labral ossification was observed in 78.3% of all patients, and its lateral projection length was statistically associated with failure ( P = .015).Conclusion:At a mean 12-year follow-up, hip arthroscopy for femoroacetabular impingement led to significant clinical improvement, with 55% PASS achievement. In total, 31% of patients were below the PASS threshold, 5% had revision arthroscopy, and only 9% had conversion to total hip arthroplasty for a 45% global failure rate. Increased body mass index, older age, and smaller preoperative lateral joint space width were significant negative prognostic factors. Postoperative degenerative changes were highly prevalent and demonstrated association with failure.

中文翻译：

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影响股骨髋臼撞击症髋关节镜 12 年随访结果的患者因素


背景：自 2000 年代初首次描述股骨髋臼撞击症的关节镜治疗以来，尽管仅发表了少数中期随访研究，但自此以来，关节镜治疗股骨髋臼撞击症已越来越受欢迎。 目的：描述接受髋关节镜检查治疗股骨髋臼撞击症的患者的结果平均12年随访并确定失败的危险因素。研究设计：病例对照研究；证据水平，3。方法：术前和中期随访时完成非关节炎髋关节评分（NAHS）和放射学评估。参与者根据临床进展分为两组。成功组由最终随访时 NAHS 高于既定患者可接受症状状态 (PASS) 阈值 81.9 的患者组成，而接受第二次手术干预或在最终随访时未达到 PASS 阈值的患者为分配到失败组。对这些组进行比较，以确定术前人口统计学、病理学和手术因素的差异。结果：总共纳入 95 个髋关节，其中 23 个髋关节失访（80.5% 随访）。平均随访 12.1 年（范围为 9.2-16.0 年），9 个髋关节需要进行全髋关节置换术（9.5%），5 个髋关节需要进行髋关节翻修术（5.3%），29 个髋关节未达到 NAHS PASS 阈值（30.5%） ），52 人达到了 NAHS PASS 门槛（54.7%）。最终随访时的平均 NAHS 为 82.4，而术前为 66.9（平均差异 = 15.5；P < .001）。较高的平均体重指数（24.9 vs 23.0；P = .030）、年龄较大（30.0 vs 27.2；P = .035）和术前下侧关节间隙宽度（3.9 vs 4.4；P = .019）与下颌相关。失败组与成功组的预后。 失败组中 69.2% 观察到骨关节炎进展，成功组中 34.8% 观察到骨关节炎进展 ( P = .082)。 78.3% 的患者观察到盂唇骨化，其侧向投影长度与失败存在统计学相关性 ( P = .015)。结论：在平均 12 年的随访中，髋关节镜检查治疗股骨髋臼撞击症带来了显着的临床改善，55% 的 PASS 成绩。总体而言，31% 的患者低于 PASS 阈值，5% 的患者进行了关节镜翻修术，只有 9% 的患者转为全髋关节置换术，总体失败率为 45%。体重指数增加、年龄较大和术前外侧关节间隙宽度较小是显着的负面预后因素。术后退行性变化非常普遍，并被证明与失败有关。