FP6.1 Has Surgical Evolution in Hip Arthroscopic Techniques Improved Patient Reported Outcome following Treatment of Symptomatic Femoro-Acetabular Impingement (FAI)

Abstract ICLA06 - Finetuning FAI Surgery: Advanced Corrections and Avoiding Yatrogenic Instability, Auditorium A (BMCC Level 1), October 8, 2026, 14:00 - 16:00 Background Hip arthroscopy for femoroacetabular impingement (FAI) has undergone substantial technical advancements. Whether these combined improvements have led to measurable clinical benefit is unknown. Aim To compare 2-year outcomes between two surgical eras separated by 10 years and determine whether contemporary surgical approaches yielded greater treatment benefit. Study Design: Cohort Study Methods Prospectively collected registry data of primary hip arthroscopies for FAI were reviewed comparing patients treated between 2010 and 2012 (Early Group) and those treated between 2020 and 2022 (Contemporary Group). Outcomes comprised of survivorship, repeat arthroscopy, patient reported outcomes (PROMs; mHHS, UCLA, SF36, and WOMAC), range of motion and satisfaction at two years. Survivorship was compared using a Kaplan-Meier Curve. Between-group comparisons for continuous data were performed using Mann Whitney U tests, and Wilcoxon Signed Ranks for within-group comparisons. Reoperation rates and satisfaction rates were compared using Chi Squared analysis. Results A total of 658 cases met the inclusion (Early Group: n=347; Contemporary Group: n=311). The Contemporary Group underwent significantly greater bony correction for both LCEA (–6° vs 0° change, p<0.001) and alpha angle (–10° vs –6°, p<0.001). All patients in the Contemporary Group underwent capsular repair. The Contemporary Group had higher rates of anatomical labral cuff repair. Despite these technical advances, survivorship (97% vs 98%, p=0.379), and rates of repeat arthroscopy (8.4% vs 6.4%, p=0.242) were similar. Both groups demonstrated significant improvements across all PROMs (all p<0.001). The Early Group demonstrated greater improvements in ROM, whereas the Contemporary Group showed more limited ROM gains despite more extensive bony correction. Finally, satisfaction was high in both groups (85% vs 80%, p=0.108). Conclusion Despite substantial technical evolution in arthroscopy, including the introduction of capsular repair, anatomical labral preservation and more refined bony correction; surgical advancements in FAI treatment did not lead to superior outcomes at 2 years. Both surgical eras provided improvements in pain and function, high survivorship and high satisfaction. The findings reinforce that in the appropriate patient, hip arthroscopy is a consistently effective treatment option for symptomatic FAI and the clinical benefits of treatment have remained stable despite technical advances.