scholarly journals Arthroscopic treatment of pincer-type femoroacetabular impingement performing acetabuloplasty without labral detachment

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0001
Author(s):  
Fernando Comba ◽  
Pablo Slullitel ◽  
Pedro Bronenberg ◽  
Martin Buttaro ◽  
Gerardo Zanotti ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Visual Analogue Scale ◽  
Clinical Outcomes ◽  
Analogue Scale ◽  
Harris Hip Score ◽  
Crossover Sign ◽  
Center Edge ◽  
Labral Refixation ◽  
Modified Harris Hip Score ◽  
Acetabular Rim

Objectives: In order to access and resect the acetabular rim, arthroscopic acetabuloplasty was described with labral detachment. However, when the chondrolabral junction remains intact, acetabuloplasty and labral refixation can be performed maintaining an unharmed labrum. We aimed to evaluate the outcome of a group of patients treated with arthroscopic acetabuloplasty without labral detachment. Methods: During the study period, we retrospectively analyzed 44 patients with pincer-type o combined impingement and an intact chondroblabral junction, with an average followup of 32 months (range: 27-38). We excluded patients with CAM-type impingement and previous hip pathology. Radiographs were analyzed to define impingement and classify grade of osteoarthritis. Clinical evaluation consisted of preoperative and postoperative modified Harris Hip Score (mHHS) and WOMAC as well as postoperative Visual Analogue Scale (VAS) of pain and satisfaction. Reoperations were considered surgical failures for purposes of survival analysis.. Results: Mean preoperative anterior and lateral center-edge angles were 35º and 29º, respectively. Mean preoperative alfa angle was 52º. Crossover sign was found in 82% of cases. mHHS changed from 51.06 (SD 4.81) preoperatively to 84.97 (SD 12.79) postoperatively. Preoperative WOMAC was 29.18 (SD 8) and postoperative, 13.10 (SD 11). Postoperative VAS was 7.5 and 2.27 for satisfaction and pain, respectively. When comparing patients with Tönnis 0 to those with Tönnis 1, the former showed better results regarding postoperative mHHS (89.9s vs 77.85, p=0.03), pain VAS (1.5 vs 6.3, p=0.03) and satisfaction VAS (8.2 vs 6.3, p=0.01). Postoperative WOMAC was slightly better for Tönnis 0 patients (8.31 vs 19.3, p=0.05). No differences were found in preoperative WOMAC and mHHS. Three of 44 patients required a second surgical procedure and were considered failures. Survival was 100% at 24 months and 76% at 40 months (95%CI: 35%-98%). Conclusion: Arthroscopic acetabuloplasty without labral detachment achieved good clinical outcomes in all the evaluated scores. Slight degenerative changes on radiographs correlated with poorer clinical outcomes, exhibiting better results in patients without osteoarthritis.

scholarly journals Patients with a Hypoplastic Labrum Achieve Similar Outcomes After Primary Labral Repair in the Treatment of Femoracetablular Impingement Syndrome Compared to Patients with a Normal Labrum

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0043
Author(s):  
Justin Drager ◽  
Alexander Newhouse ◽  
Jorge Chahla ◽  
Shane Nho ◽  
Jonathan Rasio
Keyword(s):  
Clinical Outcomes ◽  
Demographic Data ◽  
Impingement Syndrome ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Score Improvement ◽  
Center Edge ◽  
Patient Reported ◽  
Outcome Tool ◽  
Modified Harris Hip Score

Objectives: A preoperative or intraoperative finding of an acetabular labrum width of <4mm is often cited as an indication for performing primary labral reconstruction over repair in the surgical correction of Femoracetablular Impingement Syndrome (FAIS). The purpose of this study is to compare patient reported clinical outcomes and rates of reaching Minimum Clinical Important Differences (MCID) and Patient Acceptable Symptomatic State (PASS) between patients with a hypoplastic labrum compared to those with a normal labrum width at a minimum 1 year from arthroscopic treatment of FAIS. Methods: Data from consecutive patients who underwent primary hip arthroscopy between November 2015 and July 2018 for the treatment of FAIS were analyzed. Baseline demographic data, preoperative, and minimum 1 year post-operative clinical outcomes including Hip Outcome Score-Activities of Daily Living (HOS-ADL), HOS-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), international Hip Outcome Tool 12 questions (iHOT-12), and visual analog scale (VAS) for pain and satisfaction were recorded. The labrum size was documented by the senior surgeon for all patients using the tip of an arthroscopic probe measuring 4mm. Labrum hypoplasia was defined as a labrum width at the 12 o’clock position of <4mm and normal labrum was defined as labrum width between 4 and 7mm. Patients with hypoplastic labrum were matched 1:1 by age and BMI to patients with normal labrum width. All patients underwent arthroscopic labral repair in addition to impingement resection and capsular repair. The groups were further compared after separating by acetabular coverage, in which a Lateral Center Edge Angle of 18-24.9 was considered borderline dysplastic and 25-40 was considered normal. Rates of achieving MCID calculated using a distribution-based method and PASS calculated using an anchor-based method. Results: A total of 360 patients were included in the study with 180 in each of the normal and hypoplastic groups. There was no significant differences seen in 1-year post operative outcome scores or score improvement between the two groups. When examining only borderline dysplastic patients there were no significant differences in outcomes between normal and hypoplastic labrum patients. In the subset with a normal LCEA only post-operative VAS satisfaction (85.5 ± 19.3 vs 78.2 ± 27.4; p=0.050) was significantly higher in the normal labrum patients compared to hypoplastic labrum. Patients with hypoplastic labrum achieved MCID and PASS at the same rate as patients with normal labrum across all outcome measures. Conclusions: Patients with an intraoperative finding of labral hypoplasia achieve 1-year meaningful clinical outcome at the same rate as those with normal labral width following arthroscopic labral repair. These results bring into question the need for primary labral reconstruction in patients with labral hypoplasia with a normal or borderline dysplastic acetabulum.

Risk of Conversion to Arthroplasty After Hip Arthroscopy: Validation of a Published Risk Score Using an Independent, Prospectively Collected Database

2021 ◽  
pp. 036354652199382
Author(s):  
Mario Hevesi ◽  
Devin P. Leland ◽  
Philip J. Rosinsky ◽  
Ajay C. Lall ◽  
Benjamin G. Domb ◽  
...  
Keyword(s):  
Risk Score ◽  
Roc Curve ◽  
Hip Arthroscopy ◽  
External Validation ◽  
Area Under The Curve ◽  
Harris Hip Score ◽  
Brier Score ◽  
Level Of Evidence ◽  
Center Edge ◽  
Modified Harris Hip Score

Background: Hip arthroscopy is rapidly advancing and increasingly commonly performed. The most common surgery after arthroscopy is total hip arthroplasty (THA), which unfortunately occurs within 2 years of arthroscopy in up to 10% of patients. Predictive models for conversion to THA, such as that proposed by Redmond et al, have potentially substantial value in perioperative counseling and decreasing early arthroscopy failures; however, these models need to be externally validated to demonstrate broad applicability. Purpose: To utilize an independent, prospectively collected database to externally validate a previously published risk calculator by determining its accuracy in predicting conversion of hip arthroscopy to THA at a minimum 2-year follow-up. Study Design: Cohort study (diagnosis); Level of evidence, 1. Methods: Hip arthroscopies performed at a single center between November 2015 and March 2017 were reviewed. Patients were assessed pre- and intraoperatively for components of the THA risk score studied—namely, age, modified Harris Hip Score, lateral center-edge angle, revision procedure, femoral version, and femoral and acetabular Outerbridge scores—and followed for a minimum of 2 years. Conversion to THA was determined along with the risk score’s receiver operating characteristic (ROC) curve and Brier score calibration characteristics. Results: A total of 187 patients (43 men, 144 women, mean age, 36.0 ± 12.4 years) underwent hip arthroscopy and were followed for a mean of 2.9 ± 0.85 years (range, 2.0-5.5 years), with 13 patients (7%) converting to THA at a mean of 1.6 ± 0.9 years. Patients who converted to THA had a mean predicted arthroplasty risk of 22.6% ± 12.0%, compared with patients who remained arthroplasty-free with a predicted risk of 4.6% ± 5.3% ( P < .01). The Brier score for the calculator was 0.04 ( P = .53), which was not statistically different from ideal calibration, and the calculator demonstrated a satisfactory area under the curve of 0.894 ( P < .001). Conclusion: This external validation study supported our hypothesis in that the THA risk score described by Redmond et al was found to accurately predict which patients undergoing hip arthroscopy were at risk for converting to subsequent arthroplasty, with satisfactory discriminatory, ROC curve, and Brier score calibration characteristics. These findings are important in that they provide surgeons with validated tools to identify the patients at greatest risk for failure after hip arthroscopy and assist in perioperative counseling and decision making.

Hip Arthroscopic Management Can Improve Osteitis Pubis and Bone Marrow Edema in Competitive Soccer Players With Femoroacetabular Impingement

2019 ◽  
Vol 47 (2) ◽  
pp. 408-419 ◽  
Author(s):  
Masayoshi Saito ◽  
Hajime Utsunomiya ◽  
Akihisa Hatakeyama ◽  
Hirotaka Nakashima ◽  
Haruki Nishimura ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Femoroacetabular Impingement ◽  
Bone Marrow Edema ◽  
Soccer Players ◽  
Harris Hip Score ◽  
Osteitis Pubis ◽  
Arthroscopic Management ◽  
Modified Harris Hip Score ◽  
Marrow Edema

Background: There is a dearth of knowledge regarding the correlation between femoroacetabular impingement (FAI) and osteitis pubis (OP) among symptomatic soccer players. Purpose: To elucidate whether arthroscopic FAI correction is effective for young competitive soccer players with FAI combined with OP or perisymphyseal pubic bone marrow edema (BME). Study Design: Case series; Level of evidence, 4. Methods: A total of 577 consecutive patients who underwent arthroscopic FAI correction were retrospectively reviewed with a minimum 2-year follow-up. Competitive soccer players who were professional, college, and high school athletes were included. The authors assessed the modified Harris Hip Score and Nonarthritic Hip Score preoperatively and at 6 months, 1 year, and 2 years after surgery. In addition, players were divided into groups according to radiographic evidence of OP and BME (2 groups each). Clinical outcomes, return to play, and radiographic assessments were compared between groups. Results: Twenty-eight hips met the inclusion criteria. The median modified Harris Hip Score significantly improved after hip arthroscopy (81.4, preoperatively; 95.7 at 6 months, P = .0065; 100 at 1 year, P = .0098; 100 at 2 years, P = .013). The median Nonarthritic Hip Score also significantly improved (75.0, preoperatively; 96.3 at 6 months, P = .015; 98.8 at 1 year, P = .0029; 100 at 2 years, P = .015). Furthermore, 92.0% of players returned to play soccer at the same or higher level of competition at a median 5.5 months (range, 4-15 months); 67.8% had radiological confirmation of OP; and 35.7% had pubic BME. The alpha angle was significantly higher in pubic BME group than the no–pubic BME group (64.8° vs 59.2°, P = .027), although there was no significant difference between the OP and no-OP groups. The prevalence of tenderness of the pubic symphysis significantly decreased preoperatively (32.1%) to postoperatively (3.6%). Magnetic resonance imaging findings confirmed that pubic BME disappeared in all players at a median 11 months (range, 6-36) after initial surgery. Conclusions: Arthroscopic management for FAI provides favorable clinical outcomes, a high rate of return to sports, and, when present, resolution of pubic BME among competitive soccer players.

Clinical Outcomes after Arthroscopic Treatment of Synovial Chondromatosis in the Hip

Cartilage ◽  
2020 ◽  
pp. 194760352091231
Author(s):  
Xin Zhang ◽  
Guanying Gao ◽  
Jianquan Wang ◽  
Yan Xu
Keyword(s):  
Clinical Outcomes ◽  
Clinical Results ◽  
Synovial Chondromatosis ◽  
Arthroscopic Treatment ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Study Cohort ◽  
Before And After ◽  
Vas Scores ◽  
Modified Harris Hip Score

Purpose Evaluate the clinical outcomes after arthroscopic treatment of synovial chondromatosis (SC) of the hip. Materials and Methods We evaluated patients who underwent arthroscopic management for SC of the hip from November 2008 to March 2017. Radiographic evaluation was made before and after surgery. The modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), visual analogue scale (VAS) score, and patient self-reported satisfaction were collected and analyzed before and after surgery. Complications and recurrence that occurred after surgery were recorded. Results Forty-one patients (27 men and 14 women) were the study cohort. The mHHS improved from 67.0 to 83.7, HOOS-Symptoms improved from 78.8 to 93.3, HOOS-Pain improved from 80.9 to 93.6, HOOS-Activity Limitations–Daily Living improved from 84.5 to 95.1, HOOS-Sport improved from 50.3 to 80.6, and HOOS-Quality of Life improved from 62.2 to 86.7. VAS scores decreased from 3.9 to 1.1. All results demonstrated significant improvement ( P < 0.05). Thirty-three (80.5%) patients thought the outcome of surgery was “excellent,” 7 (17.0%) thought it was “good,” 1 (2.4%) thought it was “fair,” and no one thought it was “poor”. Two patients underwent revision surgery. Conclusion Hip arthroscopy for SC treatment of the hip showed good clinical results, good satisfaction from patients, and low recurrent prevalence.

Recombinant human FGF-2 therapy for osteonecrosis of the femoral head: 5-year follow-up

2020 ◽  
Author(s):  
Yutaka Kuroda ◽  
Toshiko Ito-Ihara ◽  
Hiroyasu Abe ◽  
Manabu Nankaku ◽  
Yaichiro Okuzu ◽  
...  
Keyword(s):  
Los Angeles ◽  
Femoral Head ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Rating Scale ◽  
Scoring Systems ◽  
Harris Hip Score ◽  
Postoperative Mri ◽  
Radiological Changes ◽  
Activity Rating

Aim: To evaluate the 5-year outcomes from the prospective study of recombinant human FGF-2 (rhFGF-2) for osteonecrosis of the femoral head (ONFH). Methods: Ten patients (average age 39.8 years) with nontraumatic, precollapse ONFH were percutaneously administered with 800 μg rhFGF-2 contained in gelatin hydrogel. Radiological changes and the prevalidated Harris hip score (HHS), visual analogue scale for pain and University of California, Los Angeles activity-rating scale scoring systems were evaluated. Results: The 5-year comparison in type C2 showed higher joint preservation in the rhFGF-2 group (71.4%) than in the natural course group (15.4%). Two of three clinical scores (Harris hip score and visual analogue scale for pain) improved significantly. Postoperative MRI demonstrated significant reduction in ONFH size. There were no adverse events. Conclusion: rhFGF-2 treatment for ONFH appears to be safe and effective and may have the potential to prevent disease progression.

scholarly journals Is Hip Arthroscopy Effective in Patients With Combined Excessive Femoral Anteversion and Borderline Dysplasia? A Match-Controlled Study

2018 ◽  
Vol 47 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Edwin O. Chaharbakhshi ◽  
David E. Hartigan ◽  
Itay Perets ◽  
Benjamin G. Domb
Keyword(s):  
Hip Arthroscopy ◽  
Femoral Anteversion ◽  
Harris Hip Score ◽  
Control Group ◽  
Edge Angle ◽  
Center Edge ◽  
Modified Harris Hip Score ◽  
Lateral Center Edge Angle ◽  
Center Edge Angle

Background: Appropriate patient selection is critical when hip arthroscopy is considered in the setting of borderline dysplasia (BD). It is presumable that excessive femoral anteversion (EFA) and BD may contraindicate arthroscopy. Hypothesis: Patients with combined EFA and BD (EFABD) demonstrate significantly inferior short-term outcomes after arthroscopic labral preservation and capsular closure when compared with a similar control group with normal lateral coverage and femoral anteversion. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on patients undergoing hip arthroscopy between April 2010 and November 2014. The EFABD group’s inclusion criteria were BD (lateral center-edge angle, 18°-25°), labral tear, capsular closure, and femoral version ≥20°, as well as preoperative modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, and visual analog scale. Exclusion criteria were workers’ compensation, preoperative Tönnis grade >1, microfracture, abductor pathology, or previous ipsilateral hip surgery or conditions. Patients in the EFABD group were matched 1:2 to a similar control group with normal coverage and femoral anteversion by age at surgery ± 6 years, sex, body mass index ± 5, acetabular Outerbridge grade (0, 1 vs 2, 3, 4), and iliopsoas fractional lengthening. Results: Sixteen EFABD cases were eligible for inclusion, and 100% follow-up was obtained at ≥2 years postoperatively. Twelve EFABD cases were matched to 24 control cases. Mean femoral version was 22.4° in the EFABD group and 10.2° in the control group ( P = .01). Mean lateral center-edge angle was 22.1° in the EFABD group and 31.5° in the control group ( P < .0001). Acetabuloplasty was performed significantly more frequently in the control group ( P = .0006). No other significant differences were found regarding demographics, findings, procedures, or preoperative scores. At latest follow-up, the EFABD group demonstrated significantly lower mean modified Harris Hip Score (76.1 vs 85.9; P = .005), Nonarthritic Hip Score (74.8 vs 88.5; P < .0001), Hip Outcome Score–Sports Specific Subscale (58.3 vs 78.4; P = .02), and patient satisfaction (7.1 vs 8.3; P = .005). There were 4 secondary surgical procedures (33.3%) in the EFABD group and 1 (4.2%) in the control group ( P = .03). One patient in each group required arthroplasty. Conclusion: Patients treated with arthroscopic labral preservation and capsular closure in the setting of EFABD demonstrated significant improvements from presurgery to latest follow-up. However, their results are significantly inferior when compared with a matched-controlled group. Consideration of periacetabular osteotomy or femoral osteotomy may be warranted in the setting of EFABD to achieve optimal benefit.

scholarly journals Correlations between the Harris Hip Score and the Visual Analogue Scale in the assessment of total hip replacement in hip dysplasia

2014 ◽  
Vol 20 (1) ◽  
pp. 6-13
Author(s):  
Zuh S.G ◽  
Nagy Ö. ◽  
Zazgyva Ancuța ◽  
Russu O.M. ◽  
Gergely I. ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Analogue Scale ◽  
Hip Dysplasia ◽  
Correlation Coefficients ◽  
Harris Hip Score ◽  
Total Hip ◽  
Postoperative Changes ◽  
Patient Reported

ABSTRACT Total hip replacement is one of the most frequently performed orthopaedic interventions that can significantly improve the functional status and the quality of life of patients suffering from hip arthrosis. Recently patient satisfaction and patient-reported results of total hip arthroplasty are increasingly emphasised as important tools for the assessments of these interventions. For patients with arthrosis secondary to hip dysplasia, these evaluations can be more difficult, due to younger age and higher functional demands. In this study we compared the Visual Analogue Scale and the Harris Hip Score in order to determine the correlations between these instruments and analyse the possibility of replacing the Harris Score with the Visual Analogue Scale in evaluating the results of hip surgery in patients with dysplastic hips. Our study included 37 women and 4 men (53 hips), with a mean age of 50.96 years (35-58 years), followed for a mean of 4 years postoperatively. Both assessment instruments were used preoperatively and at the follow-up visits. We observed a positive correlation of the values of the Visual Analogue Scale and the Harris Hip Score both preoperatively and postoperatively, with correlation coefficients of +0.71(P <0.001) and +0.77 (P <0.001) respectively. Given these positive correlations, we assumed that the Visual Analogue Scale could replace the Harris Hip Score in the evaluation of patients after total hip replacement. Still it is recommended to combine the Visual Analogue Scale with objective measurements and radiological examination in order to identify significant postoperative changes.

scholarly journals Outcomes of arthroscopic femoroplasty in patients with cam lesions: Minimum 2-year follow-up

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902094204
Author(s):  
Yong-Chan Ha ◽  
Jae-Young Lim ◽  
Yoo-Sun Won ◽  
Young-Kyun Lee ◽  
Kyung-Hoi Koo ◽  
...  
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Visual Analog Scale Score ◽  
Harris Hip Score ◽  
Preoperative Pain ◽  
Military Population ◽  
Modified Harris Hip Score

Purpose: Successful arthroscopic femoroplasty in patients with cam lesions have been reported in Western countries in the last two decades. However, the outcomes after arthroscopic femoroplasty in Asia have thus far only been reported in patients with borderline dysplasia and in the military population. This retrospective study was designed to evaluate the short-term clinical outcomes and radiologic outcomes after hip arthroscopy in patients with cam-type femoroacetabular impingement (FAI) at a minimum postoperative follow-up of 2 years. Methods: From January 2013 to December 2016, 204 hip arthroscopy procedures were performed. Of these cases, 62 patients (73 hips) underwent hip arthroscopy for cam-type FAI. Results: Of the 73 hips, 65 (89.0%) achieved gratified reduction or elimination of preoperative pain. The clinical outcomes showed improvement in scores from before surgery to the last follow-up: 67.1 ± 15.0 to 90.2 ± 6.3 for the modified Harris hip score ( p < 0.001), 4.7 ± 2.5 to 7.1 ± 1.4 for the University of California Los Angeles score ( p < 0.001), and 7.4 ± 1.9 to 1.8 ± 1.5 for the visual analog scale score ( p < 0.001). In radiologic assessments, significant improvement was observed in the alpha angle from a mean 60.9° to 49.5° ( p < 0.001) and in the head–neck offset from a mean of 3.3 mm to 6.3 mm ( p < 0.001). Of the 73 hips, 65 (89.0%) achieved satisfactory reduction or elimination of preoperative pain. In subgroup analysis for the sufficiency of femoroplasty (alpha angle < 55°), the clinical outcomes were not different between the two groups. Conclusion: Arthroscopic femoroplasty resulted in an 89% satisfaction at the 2-year follow-up. Therefore, hip arthroscopic femoroplasty might be an excellent alternative to open surgery and offers a greater probability of good to excellent results.

Trapeziometacarpal arthrodesis: is bone union necessary for a good outcome?

2014 ◽  
Vol 40 (4) ◽  
pp. 356-361 ◽  
Author(s):  
F. Smeraglia ◽  
A. Soldati ◽  
G. Orabona ◽  
A. Ivone ◽  
G. Balato ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Visual Analogue Scale ◽  
Clinical Outcomes ◽  
Analogue Scale ◽  
Bone Union ◽  
Dash Score ◽  
Good Outcome

We present a retrospective study of 107 cases of thumb carpometacarpl joint arthrodesis. The aim of our study was to analyse our population and to compare the outcomes of patients who obtained bone union with the patients who did not. There were no statistical differences in most of the clinical outcomes (DASH score, visual analogue scale, Kapandji test, grip, and key pinch) between the two groups of patients; there were fewer cases of scaphotrapeziotrapezoid arthritis in the group that did not obtain bone union. We conclude that the bone union is not necessary for a good outcome. Level IV of evidence

Predictors of Clinical Outcomes After Hip Arthroscopy: 5-Year Follow-up Analysis of 1038 Patients

2020 ◽  
Vol 49 (1) ◽  
pp. 112-120 ◽  
Author(s):  
Benjamin G. Domb ◽  
Sarah L. Chen ◽  
Cammille C. Go ◽  
Jacob Shapira ◽  
Philip J. Rosinsky ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Predictive Factors ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Joint Space ◽  
Harris Hip Score ◽  
Bivariate Analysis ◽  
Inclusion Criteria ◽  
Modified Harris Hip Score

Background: Although hip arthroscopy has been shown to have favorable results, there is a paucity of literature describing predictive factors of 5-year clinical outcomes. Purpose: To identify predictive factors of midterm outcomes after hip arthroscopy in a cohort of 1038 patients whose outcomes at minimum 2-year follow-up were previously reported. In addition, to provide a comparison of short- and midterm predictive factors in outcome measures after hip arthroscopy. Study Design: Case-control study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing hip arthroscopy between February 2008 and June 2012. Patients were included if they had minimum 5-year follow-up on 2 patient-reported outcomes: Nonarthritic Hip Score (NAHS) and modified Harris Hip Score. Patients were excluded if they had any previous ipsilateral hip conditions. Using bivariate and multivariate analyses, we analyzed the effect of 36 pre- and intraoperative variables on the NAHS, modified Harris Hip Score, and conversion to total hip arthroplasty. Results: A total of 1038 patients met the inclusion criteria for the 2-year study, and 860 met our listed inclusion criteria for the 5-year study. The mean follow-up time was 62.0 months (range, 60.0-120.0 months). The bivariate analysis identified 10 variables (4 categorical and 6 continuous) that were predictive of 5-year postoperative NAHS. For the multivariate analysis, 7 variables were identified as being significant: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. These 7 variables were also predictive in the bivariate analysis. Age, BMI, revision hip arthroscopy, Tönnis grade, sex, trochanteric bursectomy, femoral head cartilage damage, and acetabular inclination were significant predictors of conversion to total hip arthroplasty. Conclusion: This study reports favorable midterm clinical outcomes in the largest cohort of hip arthroscopies with minimum 5-year follow-up in the literature to date. Seven variables were identified as being significant predictors of postoperative NAHS in the bivariate and multivariate analyses: preoperative NAHS, BMI, age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. Of these, preoperative NAHS, BMI, age, and revision hip arthroscopy were predictive of 2- and 5-year postoperative NAHS. These predictive factors may prove useful to clinicians in determining indications for hip arthroscopy and counseling patients on its expected outcomes.

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