EP8.67 Outcomes Following Contemporary Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review of Labral Repair, Capsular Closure, and Osteochondroplasty

Abstract Introduction Hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has undergone significant technical evolution since its inception, with evolution to labral repair, capsular closure, and osteochondroplasty in contemporary practice. While hip arthroscopy outcomes literature has evaluated these components in isolation, outcomes of combined contemporary hip arthroscopy techniques have not been systematically characterized. Methods A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, across PubMed, Embase, and Scopus. Eligible studies included those with minimum 2-year follow up of FAIS when treated arthroscopically with labral repair, capsular closure, and osteochondroplasty in >90% of cases. Extracted data included baseline demographics, modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), revision arthroscopy rates, and conversion to total hip arthroplasty (THA). Change in scores from preoperative to postoperative states, as well as rates of achieving clinically important thresholds such as the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS), were also extracted. Results Twelve studies encompassing 2,591 hips with a mean follow-up of 40 months were included. Most studies (75%) were Level III evidence. The mean patient age was 33 years, and 53% of patients were female. Mean mHHS improved by 25.4 points (range 20.0-33.3), with MCID achieved in 84.8% (range 74–100%) and PASS achieved in 85.9% (range 70.9–100%) of patients. Mean HOS-ADL improved by 26.2 points (18.0-33.7), with MCID achieved in 79.2% (68-98.3%) and PASS achieved in 75.1% (53.6-82.1%) of patients. Mean HOS-SS improved 33.4 points (23.3-46.7), with MCID achieved in 85.6% (78.5-96.7%) and PASS achieved in 72.2% (49.2-93.5%) of patients. Conversions to THA occurred in 1.7% (0-6.4%) of cases, with revision hip arthroscopy occurring in 5.1% (0-16%). Conclusion Contemporary hip arthroscopy incorporating labral repair, capsular closure, and osteochondroplasty produces clinically meaningful improvements across patient-reported outcomes at a minimum follow-up of 24 months. Additionally, rates of conversion to THA and revision arthroscopy were low among included studies. These findings establish a benchmark for outcomes under a standardized definition of contemporary hip arthroscopy.