EP8.75 Hip Arthroscopy for Femoroacetabular Impingement Syndrome Yields Durable Functional Improvements and Comparable Reoperation Rates in Patients Over 50 Years Old at Average 15-Year Follow-Up

Abstract Introduction Although prior studies have demonstrated improved functional outcomes at short- and mid-term follow-up of hip arthroscopy for FAIS in patients over 50, the durability of these outcomes at long-term follow-up remains unclear. The purpose of this study was to evaluate the impact of age on long-term functional outcomes and failure rates following HA for FAIS. Methods A retrospective review was conducted of a prospectively collected cohort who underwent HA for FAIS from January 2007 to March 2012 with an average of 15-years follow-up. Patients aged <50 years were matched in a 3:1 ratio to those aged ≥50 years based on sex, BMI, and Tönnis grade. Patient-reported outcome measures, including the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS), were collected preoperatively and at 15-year follow-up. Rates of achieving clinically meaningful thresholds (MCID, PASS, and SCB), radiographic parameters, and reoperation rates were also compared between cohorts. Results Fifty-four patients <50 years were matched to 18 patients ≥50. Baseline characteristics were comparable between groups, including follow-up duration (15.1 ± 0.7 years, P = 0.723), BMI (26.9 ± 4.7 kg/m2, P = 0.487), sex distribution (63% female, P = 0.888), and Tönnis grade (P = 1.000). At 15 years, both cohorts demonstrated similar improvements in mHHS (51.9 ± 13.5, P = 0.470) and NAHS (48.9 ± 11.9, P = 0.443), as well as MCID (mHHS: 93.1%, P = 0.181; NAHS: 91.7%, P = 1.000), PASS (mHHS: 72.2%, P = 0.362; NAHS: 68.1%, P = 0.108), and SCB (mHHS: 62.5%, P = 0.673; NAHS: 43.1%, P = 0.492) achievement. Younger patients demonstrated decreased postoperative alpha angles (1.5° ± 4.8°, P = 0.013) and lateral center-edge angles (LCEA) (0.9° ± 2.3°, P = 0.005). There was no difference in reoperation rates between groups (15.3% P = 0.571). Conclusion Patients above and below 50 years of age demonstrated durable functional and clinical outcomes at 15-year follow-up. In appropriately selected patients, age alone should not be a contraindication to hip arthroscopy for FAIS.