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Topic:

Femoral Acetabular Impingement

Issue:

Hip

Category:

Developmental

Title:

Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient

Author:

Yen, Yi-Meng MD, PhD; Kim, Young-Jo MD, PhD; Ellis, Henry B. MD; Sink, Ernest L. MD; Millis, Michael B. MD; Zaltz, Ira MD; Sankar, Wudbhav N. MD; Clohisy, John C. MD; ANCHOR Group; Nepple, Jeffrey J. MD, MS

Journal:

Journal of Pediatric Orthopaedics

Date:

March 2024

Reference:

44(3): p 141-146, DOI: 10.1097/BPO.0000000000002581

Level Of Evidence:

III

# of Patients:

126

Study Type:

Retrospective cohort study

Location:

Multicenter cohort

Summary:

This study evaluates the clinical outcomes of femoroacetabular impingement (FAI) surgery in adolescents and identifies risk factors for suboptimal outcomes.

Methods:

The cohort consisted of 126 adolescent hips undergoing surgery for symptomatic FAI. Clinical outcomes were assessed using modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score (HOOS), and University of California Los Angeles activity score. Failure was defined as revision surgery or clinical failure. Statistical analysis was conducted to identify factors associated with failure.

Exclusions:

None specified

Results:

Overall, 18.3% failure rate, with 8.7% requiring revision surgery. Females had a higher failure rate (25.7%) compared to males (7.7%, p=0.01), partly due to lower preoperative mHHS scores. Mild cam deformities were more common in females (42.5% vs. 17.3% in males). Higher alpha angles correlated with lower failure rates. Failure rates: 63 degrees: 8.3% 55-63 degrees: 12.0% <55 degrees (mild cam): 37.5% Athletes had a 10.3% failure rate vs. non-athletes (25.0%, p=0.03, RR=2.4).

Conclusions:

Most adolescents undergoing FAI surgery showed significant improvement, but females, mild cam deformities, and lack of sports participation were associated with higher failure rates. These factors should be considered in surgical decision-making and patient counseling.

Relevance:

Limitations:

Perspective:

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