Abstract：
OBJECTIVE: The purpose of the present study was to compare clinical outcomes and rates of secondary surgery, including revision hip arthroscopy and conversion to total hip arthroplasty (THA), after primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in patients ≥40 years of age at minimum 10-year follow-up compared with a propensity-matched control group of patients <40 years.
METHODS: A retrospective cohort study was performed for patients who underwent primary hip arthroscopy for FAIS between January 2012 and February 2013. Patients ≥40 years old were propensity matched in a 1:1 ratio by sex and body mass index to patients <40 years old. Patient-reported outcomes (PROs) including Hip Outcome Score for Activities of Daily Living and Sports-Specific subscales, modified Harris Hip, International Hip Outcome Tool-12, and Visual Analog Scale for Pain and Satisfaction were collected. Rates of minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS) achievement at 10 years were evaluated and compared between groups. Rates of secondary surgery including revision hip arthroscopy and conversion to THA were evaluated. Gross survivorship between cohorts was evaluated using a Kaplan-Meier curve.
RESULTS: Fifty-three patients aged ≥40 (age 48.3 ± 5.8 years) were successfully matched to 53 patients aged <40 (age: 28.9 ± 7.2, <0.001). There were no other preoperative group differences regarding patient demographics, characteristics, or radiographic findings. Both groups demonstrated significant improvement regarding all PROs at a minimum of 10 years\' follow-up (P < .001 for all). No significant difference was noted between cohorts regarding any delta (preoperative to 10-year postoperative) scores (P > .05 for all). High rates of MCID and PASS achievement were achieved in both cohorts, with no significant differences in any PRO measure (P > .05 for all). No significant differences in rates of complications (age ≥40: 2.0%, age <40: 7.7%, P = .363), rates of revision (age ≥40: 7.5%, age <40: 9.4%, P = .999), or conversion to THA (age ≥40: 13.2%, age <40: 3.8%, P = .161) were identified. On Kaplan-Meier analysis, no significant difference (P = .321) was demonstrated in overall gross survivorship between cohorts.
CONCLUSIONS: Patients with age ≥40 with FAIS undergoing primary hip arthroscopy demonstrated durable and comparable 10-year PRO and rates of MCID and PASS achievement compared with a propensity-matched cohort of age <40 counterparts.
METHODS: Level III, retrospective comparative prognostic trial.
METHODS: A retrospective cohort study was performed for patients who underwent primary hip arthroscopy for FAIS between January 2012 and February 2013. Patients ≥40 years old were propensity matched in a 1:1 ratio by sex and body mass index to patients <40 years old. Patient-reported outcomes (PROs) including Hip Outcome Score for Activities of Daily Living and Sports-Specific subscales, modified Harris Hip, International Hip Outcome Tool-12, and Visual Analog Scale for Pain and Satisfaction were collected. Rates of minimal clinically important difference (MCID) and patient-acceptable symptomatic state (PASS) achievement at 10 years were evaluated and compared between groups. Rates of secondary surgery including revision hip arthroscopy and conversion to THA were evaluated. Gross survivorship between cohorts was evaluated using a Kaplan-Meier curve.
RESULTS: Fifty-three patients aged ≥40 (age 48.3 ± 5.8 years) were successfully matched to 53 patients aged <40 (age: 28.9 ± 7.2, <0.001). There were no other preoperative group differences regarding patient demographics, characteristics, or radiographic findings. Both groups demonstrated significant improvement regarding all PROs at a minimum of 10 years\' follow-up (P < .001 for all). No significant difference was noted between cohorts regarding any delta (preoperative to 10-year postoperative) scores (P > .05 for all). High rates of MCID and PASS achievement were achieved in both cohorts, with no significant differences in any PRO measure (P > .05 for all). No significant differences in rates of complications (age ≥40: 2.0%, age <40: 7.7%, P = .363), rates of revision (age ≥40: 7.5%, age <40: 9.4%, P = .999), or conversion to THA (age ≥40: 13.2%, age <40: 3.8%, P = .161) were identified. On Kaplan-Meier analysis, no significant difference (P = .321) was demonstrated in overall gross survivorship between cohorts.
CONCLUSIONS: Patients with age ≥40 with FAIS undergoing primary hip arthroscopy demonstrated durable and comparable 10-year PRO and rates of MCID and PASS achievement compared with a propensity-matched cohort of age <40 counterparts.
METHODS: Level III, retrospective comparative prognostic trial.
摘要：
目的：本研究的目的是比较临床结果和二次手术率，包括修订髋关节镜和转换为全髋关节置换术（THA），对于年龄≥40岁的患者，在至少10年的随访时间内进行初次髋关节镜检查以治疗股骨髋臼撞击综合征（FAIS），与倾向匹配的对照组<40岁的患者相比。
方法：对2012年1月至2013年2月因FAIS接受初次髋关节镜检查的患者进行了一项回顾性队列研究。.≥40岁的患者与<40岁的患者的性别和体重指数以1：1的比例匹配。患者报告的结果包括日常生活活动的髋关节结局评分（HOS-ADL）和运动特异性（HOS-SS）分量表，改良哈里斯髋关节（mHHS），国际髋关节结果工具-12（iHOT-12），收集疼痛和满意度视觉模拟量表（VAS）。评估并比较两组之间在10年时的最小临床重要差异率（MCID）和患者可接受的症状状态（PASS）成就。评估了二次手术的发生率，包括翻修髋关节镜检查和转换为THA。使用Kaplan-Meier曲线评估队列之间的总体生存率。
结果：年龄≥40（年龄：48.3±5.8岁）的53例患者与年龄<40（年龄：28.9±7.2，<0.001）的53例患者成功匹配。关于患者的人口统计学，没有其他术前组差异，特点,或影像学检查结果。两组在至少10年的时间内，所有PRO均表现出显着改善（全部p<0.001）。在任何delta（术前至术后10年）评分方面，队列之间没有显着差异（全部p>0.05）。在这两个队列中都实现了较高的MCID和PASS成就率，在任何PRO测量中都没有显著差异(全部p>0.05)。并发症发生率无显着差异（年龄≥40：2.0％，年龄<40岁：7.7%，p=0.363),翻修率（年龄≥40岁：7.5%，年龄<40岁：9.4%，p=0.999),或转换为THA（年龄≥40：13.2%，年龄<40：3.8%，p=0.161)被鉴定。关于Kaplan-Meier分析，队列间总体生存率无显著差异(p=0.321).
结论：年龄≥40岁的FAIS患者接受初次髋关节镜检查，与年龄<40岁的倾向匹配队列相比，其10年PRO和MCID和PASS成就率表现出持久且可比较。
方法：三级，回顾性比较预后试验。
方法：对2012年1月至2013年2月因FAIS接受初次髋关节镜检查的患者进行了一项回顾性队列研究。.≥40岁的患者与<40岁的患者的性别和体重指数以1：1的比例匹配。患者报告的结果包括日常生活活动的髋关节结局评分（HOS-ADL）和运动特异性（HOS-SS）分量表，改良哈里斯髋关节（mHHS），国际髋关节结果工具-12（iHOT-12），收集疼痛和满意度视觉模拟量表（VAS）。评估并比较两组之间在10年时的最小临床重要差异率（MCID）和患者可接受的症状状态（PASS）成就。评估了二次手术的发生率，包括翻修髋关节镜检查和转换为THA。使用Kaplan-Meier曲线评估队列之间的总体生存率。
结果：年龄≥40（年龄：48.3±5.8岁）的53例患者与年龄<40（年龄：28.9±7.2，<0.001）的53例患者成功匹配。关于患者的人口统计学，没有其他术前组差异，特点,或影像学检查结果。两组在至少10年的时间内，所有PRO均表现出显着改善（全部p<0.001）。在任何delta（术前至术后10年）评分方面，队列之间没有显着差异（全部p>0.05）。在这两个队列中都实现了较高的MCID和PASS成就率，在任何PRO测量中都没有显著差异(全部p>0.05)。并发症发生率无显着差异（年龄≥40：2.0％，年龄<40岁：7.7%，p=0.363),翻修率（年龄≥40岁：7.5%，年龄<40岁：9.4%，p=0.999),或转换为THA（年龄≥40：13.2%，年龄<40：3.8%，p=0.161)被鉴定。关于Kaplan-Meier分析，队列间总体生存率无显著差异(p=0.321).
结论：年龄≥40岁的FAIS患者接受初次髋关节镜检查，与年龄<40岁的倾向匹配队列相比，其10年PRO和MCID和PASS成就率表现出持久且可比较。
方法：三级，回顾性比较预后试验。
