FP9.4 Sequencing of Cam and Pincer Resection and its Relationship to Outcomes After Revision Hip Arthroscopy

Abstract ICLB09 - The Revision Playbook: Advanced Execution and Technical Rescues in Failed Preservation, Session Room 6 (BMCC Level 3), October 9, 2026, 10:30 - 12:30 Purpose To evaluate outcomes of revision hip arthroscopy by prior surgical procedure, revision indication, and to compare patient-reported outcomes and rates of re-revision or conversion to arthroplasty across revision indications and procedures performed. Methods A retrospective review was conducted of patients undergoing first-time revision hip arthroscopy between 2011 and 2020 at a single institution. Operative details were collected at both the index and revision surgeries, including whether cam or pincer resection was performed. Patient reported outcome measures (PROMs) were collected for patients without revision failure. Rates of re-revision arthroscopy or conversion to total hip arthroplasty (THA) were measured. Statistical analysis included appropriate tests for group comparisons and Cox proportional hazards models to identify predictors of failure. Results A total of 68 hips were included (mean age 33 ± 11.7 years, 81.2% female). The most common indications for revision were recurrent labral tear (89.9%) and residual femoroacetabular impingement (FAI) (63.8%). At index arthroscopy, 69.1% underwent cam and/or pincer resection. At the time of revision, 64.7% underwent cam and/or pincer resection, with 32.4% undergoing repeat osseous work. Labral repair (18.8%) and labral debridement (14.5%) were the most frequent soft-tissue procedures performed at revision. Patients with bony correction at only index and only revision hip arthroscopy reported comparable PROMs. Overall, 1 patient underwent repeat revision arthroscopy and 13 patients (18.8%) converted to THA at a mean of 1.4 years following revision. Labral debridement (HR 9.79, 95% CI 3.25–29.5, p < 0.001) and labral repair (HR 4.56, 95% CI 1.57–13.2, p = 0.01) were associated with higher failure risk. Conclusion Revision hip arthroscopy offers symptomatic improvement for most patients, however, failure may be more common among those with incomplete osseous correction or labral debridement at revision. Attention to comprehensive bony and soft tissue management during primary and revision procedures may reduce the risk of re-revision and conversion to arthroplasty.