Ten-Year Outcomes of Hip Arthroscopy for the Treatment of FAI and Labral Tears in Patients with a Workers' Compensation Claim
Author(s): Domb BG, Sikligar D, Keane J, McCarroll TR, Kahana-Rojkind AH, Quesada-Jimenez R.
DOI Link: 10.1016/j.arthro.2025.06.030
Background
Workers’ Compensation (WC) status has been associated with worse outcomes in orthopaedic surgery, including hip arthroscopy. This study evaluated 10-year outcomes after hip arthroscopy for femoroacetabular impingement (FAI) and labral tears in WC patients compared with a propensity-matched control group.
Methods
This retrospective Level 3 cohort study included WC patients undergoing primary hip arthroscopy between 2008 and 2013 with minimum 10-year follow-up or documented endpoint. Patients were matched 1:3 to non-WC controls based on age, sex, BMI, acetabular cartilage status, and capsular treatment. Outcomes included PROs (mHHS, NAHS, HOS-SSS), MCID and PASS achievement, return-to-work rates, revision surgery, and survivorship.
Key Findings
- 280 patients included (WC: 70; controls: 210)
- WC group had worse preoperative PROs but greater magnitude of improvement
- Comparable rates of MCID and PASS achievement between groups
- WC outcomes:
- Return to work: 82.9%
- Mean time to return: 8.0 ± 7.4 months
- Revision risk:
- WC group had ~3× higher revision rate (p < 0.001)
- Mean time to revision: 28.3 ± 37.1 months
- Long-term PROs and survivorship were otherwise comparable
Conclusion
At 10-year follow-up, WC patients achieved substantial functional improvement and similar long-term PROs compared with controls, but demonstrated a significantly higher risk of revision hip arthroscopy.
What Does This Mean for Providers?
WC status should be recognized as a risk factor for revision surgery after hip arthroscopy, even in the setting of good long-term functional improvement. Patients can still achieve meaningful outcomes, but expectations regarding durability and reoperation risk should be carefully discussed.