FP8.12 Clinical Outcomes After Hip Arthroscopy for Patients With Inflammatory Joint Disease: A Matched Control Study With Minimum 5-Year Follow-Up

Background: There is paucity in the literature regarding midterm outcomes of primary hip arthroscopy that have pre-existing inflammatory joint diseases (IJD).

Hypothesis/Purpose: We hypothesized that patients with IJDs undergoing hip arthroscopy would have significant postoperative improvement, but overall inferior outcomes compared to the control group.

Methods: Data was prospectively collected on all hip arthroscopies performed between February 2008-December 2018. Patients with IJD undergoing primary hip arthroscopy for the treatment of femoroacetabular impingement (FAI) with labral tears were included in this study. Patients were excluded if they had previous ipsilateral hip conditions other than IJDs and Tonnis grade greater than 1. Patients with minimum five-year follow-up and preoperative IJD diagnoses were 1:3 matched to controls without IJD based on age at surgery, sex, BMI, and Tonnis Grade. Patient-reported outcomes and rates of achieving clinically relevant thresholds were compared between the two groups.

Results: 27 hips (23 patients) with IJD were matched to a control group of 81 hips (79 patients). At minimum five-year follow-up both groups showed significant improvement in all PROs and VAS with similar magnitudes of improvement. The IJD group had lower postoperative PRO scores when compared to the control group and had fewer patients meet PASS for NAHS, while the IJD and control group met MCID, SCB, and PASS for remaining PROs at similar frequency. The IJD group had a 3.60-increased relative risk of a second hip surgery [relative risk: 3.60; 95% CI: 1.19 to 10.86; p< 0.05] and 4.50-increased risk of conversion to hip arthroplasty [relative risk: 4.50; 95% CI: 1.37 to 14.76; p<0.05].

Conclusion: Patients with IJD undergoing hip arthroscopy demonstrate significant improvement in all PROs at minimum five-year Follow-up. However, they reach lower postoperative PROs, achieved clinically significant benchmarks less frequently, and experienced a higher rate of revision arthroscopy and conversion to arthroplasty with a relative risk of 3.6 and 4.5 respectively when compared to a benchmark control group.