Surgical Repair of FAIS a Good Option for Adolescents

Adolescents with femoroacetabular impingement syndrome (FAIS) can achieve improved outcomes with arthroscopic repair, according to a new study.

In the study, “Hip Arthroscopy For Femoroacetabular Impingement Syndrome in Adolescents Provides Clinically Significant Outcome Benefit at Minimum 5-Year Follow-Up,” published in the May 1, 2021 issue of Arthroscopy, the researchers analyzed the rates of achieving clinically significant outcomes with surgery for these young patients.

The outcomes were defined by the minimal clinically important difference (MCID), patient acceptable symptomatic state, or substantial clinical benefit and the rates of clinical failure 5 years after undergoing hip arthroscopy for femoroacetabular impingement syndrome.

The patients, who were between the ages of 11 to 21 years of age, underwent the procedure between January 2012 and January 2015 performed by a single, fellowship trained surgeon. Clinical outcomes included Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Subscale, modified Harris hip score, international Hip Outcome Tool, and clinical failure rates at 5 years postoperatively.

The researchers defined clinical failure as revision hip arthroscopy or conversion to total hip arthroplasty.

Eighty-five patients and hips were included in the study. The average age was 17.6 ±2.5 years (range 13-21); average body mass index was 22.3 ±3.1 kg/m². Slightly more than 80% of all the patients were female and 76.2% of all patients participated in sports.

Overall, the researchers found statistically significant difference between preoperative and postoperative score averages across every outcome. At 5 years, 88.4%, 67.6% and 64.9% reached at least 1 threshold for achieving minimally clinically importance difference, patient acceptable symptomatic state and substantial clinical benefit. And 89.2% achieved at least one of the meaningful outcomes thresholds.

Two patients did fail clinically and had to undergo revision due to continued pain. None of the patients had to convert to total hip arthroplasty, however.

The researchers wrote, “This study demonstrated that a large majority (89.2%) of adolescent patients undergoing primary arthroscopic treatment for symptomatic femoroacetabular impingement syndrome achieved meaningful clinically significant outcomes.”