EP1.20 Favorable Survivorship Following Central Acetabular Decompression Irrespective of Femoral Head Cartilage Damage: Mid-Term Outcomes in Patients Undergoing Primary Hip Arthroscopy for Femoroacetabular Impingement

Introduction: Central acetabular stenosis (CAS), as defined by an osteophyte within the acetabular fossa, is associated with higher rates of femoral head chondral damage and inferior short-term outcomes following hip arthroscopy. Central acetabular decompression (CAD) is an arthroscopic technique to resect the central acetabular osteophyte and resurface the acetabular fossa to improve contact mechanics of the femoral head. The purpose of this study was to evaluate mid-term outcomes following central acetabular decompression in patients with CAS undergoing primary hip arthroscopy for femoroacetabular impingement.

Methods: A prospectively collected IRB-approved surgical database of a high-volume hip surgeon was reviewed for patients who received CAD for CAS identified during hip arthroscopy. Primary outcomes for the study was conversion to arthroplasty with secondary outcomes including revision arthroscopy and patient reported outcome scores with associated clinically relevant thresholds.

Results: Minimum five year follow up was obtained on 155 out of 189 eligible patients (82%). Within this cohort the average age was 45.9±10.8 years with 90 females (58%). At the five year time point, 30 patients (19%) had progressive osteoarthritis requiring arthroplasty while 7 patients (4.5%) had revision arthroscopy. Significant improvement for all outcome scores was observed throughout the 5-year time point with high rates of postoperative satisfaction and achievement of clinically relevant outcomes. Significant risk factors for conversion to arthroplasty included older age, higher BMI, acetabular chondral defects with Outerbridge greater than 2, and the presence of a sabertooth osteophyte.

Discussion and Conclusion: Patients with central acetabular stenosis receiving central acetabular decompression had durable postoperative improvement to the five-year time point and modest rates of conversion to arthroplasty that were associated with significant acetabular chondral damage, but not femoral chondral damage identified at the time of surgery.