EP1.77 Similar Patient Reported Functional Outcomes Following Hip Arthroscopy Versus Periacetabular Osteotomy with Concomitant Hip Arthroscopy from Pre-operative to 1 Year: A Matched Cohort Comparison

Abstract Objectives Hip arthroscopy (I-HA) addresses intra-articular pathologies from femoroacetabular impingement syndrome (FAIS), including labral tears, cam and pincer lesions, and chondral damage. In patients with developmental or borderline dysplasia, periacetabular osteotomy (PAO) may be additionally required to correct the underlying structural abnormality. Combined hip arthroscopy with PAO (HA+PAO) allows both pathologies to be addressed in a single surgical setting. While outcomes for each procedure in isolation are well studied, direct comparisons are limited. This study evaluated differences in patient-reported functional outcomes at pre-op and 1-year follow-up between I-HA and HA+PAO, hypothesizing no significant differences in iHOT-12 or HOS-ADL between groups despite the greater invasiveness of HA+PAO. Methods Patients were retrospectively identified from a single surgeon, prospectively collected database. All patients who underwent I-HA or HA+PAO with pre-operative and 1 year follow-up data consisting of complete demographics, iHOT-12, and HOS-ADL were included in the matching process. Patients were matched by sex, age at time of surgery within 3 years, and BMI at pre-operative within 3 kg/m2. Two repeated-measures ANOVA were performed to evaluate differences between surgical groups with regards to iHOT-12 and HOS-ADL over time. Pairwise comparisons were performed with Bonferroni correction applied. The assumptions of normality were met for the analysis, and α < .05 was utilized to determine significance. Results Thirty-one patients were matched, resulting in a total of 62 subjects for analysis (I-HA: 28 females, 27.3±9.8 years, 24.5±3.9 kg/m2; HA+PAO: 28 females, 27.1±10.0 years, 24.2±4.0 kg/m2). Subjects demonstrated a significant improvement from pre-operative to 1-year in both iHOT-12, F(1,60)=162.691, p<.001, and HOS-ADL, F(1,60)= 140.903, p<.001. However, surgical type was not found to have a significant effect on either outcome. Pairwise comparisons demosntrated significant differences between the surgical groups at the pre-operative time point for iHOT-12 (I-HA = 33.4±11.9, HA+PAO = 41.1±17.3, p=.047) and HOS-ADL (I-HA = 57.1±14.0, HA+PAO = 67.0±17.2, p=.016). However, no significant differences were noted between surgical groups at 1-year for iHOT-12 (I-HA = 73.9±24.1, HA+PAO = 77.7±20.3, p=.502) or HOS-ADL (I-HA = 86.3±16.1, HA+PAO = 88.2±14.6, p=.629). Both surgical groups demonstrated significant improvements in iHOT-12 and HOS-ADL from pre-operative to 1-year, p<.001. Only one complication was noted, with one individual in the I-HA cohort requiring a return to the operating room for lysis of adhesions due to arthrofibrosis. Conclusion Our findings indicate that patients undergoing I-HA and HA+PAO can expect to have similar self-reported functional outcomes at 1-year following surgery. Clinicians can use this evidence-based information when counseling patients and setting expectations that although HA+PAO may be a more invasive procedure, similar functional outcomes to patients undergoing I-HA can be expected at 1-year.