Patients Who Underwent Primary Hip Arthroscopy for Femoroacetabular Impingement with Acetabular Microfracture Show 77% Survivorship at 10-Year Follow-Up

Patients Who Underwent Primary Hip Arthroscopy for Femoroacetabular Impingement with Acetabular Microfracture Show 77% Survivorship at 10-Year Follow-Up

Authors: Domb BG, Lee MS, Annin S, Owens JS, Jimenez AE, Sabetian PW, Maldonado DR

Journal: Arthroscopy, May 2023

DOI: 10.1016/j.arthro.2022.11.018

Background

FAI with acetabular chondral lesions is a frequent cause of hip pain and dysfunction. This study assesses 10-year survivorship and patient-reported outcomes (PROs) following primary hip arthroscopy with acetabular microfracture.

Methods

• Cohort of patients undergoing primary hip arthroscopy with acetabular microfracture from June 2009 to January 2011.
• PROs assessed preoperatively and at 10 years using mHHS, NAHS, and VAS pain.
• Survivorship defined by avoidance of total hip arthroplasty (THA).

Key Findings

• 77.3% survivorship at 10 years without conversion to THA.
• Significant improvements in all PRO measures (p < 0.05).
• 83.3% achieved MCID across all PRO metrics.

Conclusions

Primary hip arthroscopy with acetabular microfracture offers durable pain relief and functional improvements, with a substantial proportion of patients avoiding THA at 10 years.

What Does This Mean for Providers?

• Acetabular microfracture during hip arthroscopy is a viable long-term joint preservation strategy for patients with chondral lesions secondary to FAI.
• Providers should consider this procedure for appropriate candidates to delay or avoid hip replacement.
• Patient selection and thorough counseling about expected outcomes and survivorship rates are essential.
• Long-term follow-up and outcome monitoring remain critical to identify patients who may eventually require arthroplasty.