Acetabular Morphologic Characteristics Predict Early Conversion to Arthroplasty After Isolated Hip Arthroscopy for Femoroacetabular Impingement
Authors: Giordano BD, Kuhns BD, Perets I, Yuen L, Domb BG
Background
While hip arthroscopy is commonly used to treat femoroacetabular impingement (FAI), outcomes can vary significantly. This study explores how acetabular morphology, particularly acetabular inclination (AI), predicts the risk of early conversion to total hip arthroplasty (THA).
Methods
A cohort of 419 patients undergoing isolated hip arthroscopy for FAI was analyzed. Preoperative radiographic variables—including AI, lateral center-edge angle (LCEA), and signs of arthritis—were assessed for their association with early progression to THA.
Key Findings
- Increased AI, older age, and cartilage damage were strong predictors of early conversion to THA.
- Patients with borderline or frank acetabular dysplasia had higher failure rates following hip arthroscopy.
- Radiographic morphology can guide risk stratification before surgery.
Conclusions
Acetabular morphology, especially AI, is a key preoperative predictor of arthroscopy failure and early THA. Accurate evaluation of AI and associated structural abnormalities should influence surgical candidacy and expectations.
What Does This Mean for Providers?
- Carefully evaluate AI, LCEA, and Tönnis grade preoperatively when considering hip arthroscopy in FAI patients.
- Borderline dysplasia or high AI should prompt consideration of alternative treatments (e.g., periacetabular osteotomy or THA in older patients).
- Providers must counsel patients about the increased risk of early arthroplasty in the setting of abnormal acetabular morphology.