Outcomes for Hip Arthroscopy Based on Sex and Age: A Comparative Matched-Group Analysis

OBJECTIVES: The purpose of this study was to compare the clinical outcomes of patients undergoing hip arthroscopy for femoroacetabular impingement (FAI) based on sex and age. METHODS: A total of 150 patients undergoing hip arthroscopy for FAI by a single fellowship-trained surgeon were prospectively analyzed, with 25 patients categorized in each of the following groups: A) females ≤30 years,B) females 31-45 years, C) females >45 years, D) males ≤30 years, E) males 31-45 years and F) males >45 years. Primary clinical outcomes included the Hip Outcome Score Activity of Daily Living (HOS-ADL) and Sport-Specific Subscales (HOS-SS), the modified Harris Hip Score (mHHS), and clinical improvement at final follow-up. Statistical analysis was performed utilizing ANOVA with post-hoc Tukey HSD tests, with P<0.05 considered significant. RESULTS: One-hundred forty of 150 patients (93%) were available for follow-up at an average 2.72±0.43 years (minimum, 2 years), with no differences in follow-up rates between the 6 groups (P<0.05). All groups demonstrated significant improvements in HOS-ADL, HOS-SS, and mHHS outcomes at final follow-up (P<0.001). Females >45 scored significantly worse on the HOS-ADL, HOS-SS, and mHHS compared to females ≤30 (P<0.0001, P=0.001, P<0.0001 respectively) and females 30-45 (P=0.015, P<0.0001, P=0.001 respectively). Similarly, males >45 scored significantly worse on the HOS-ADL, HOS-SS, and mHHS compared to males ≤30 (P=0.012, P=0.015, P=0.022 respectively) (Figure 1). Males >45 scored significantly better than females >45 on the HOS-SS (P=0.013) and the mHHS(P=0.024). Incorporating both sexes, patients >45 scored significantly worse on the HOS-ADL, HOS-SS, and mHHS compared to patients ≤30 (P<0.0001, P<0.0001, P<0.0001, respectively) and patients 30-45 (P=0.005, P<0.0001, P=0.008, respectively). CONCLUSION: While all patients had significant improvements in all outcomes following hip arthroscopy for FAI, patients >45 years performed worse compared to patients in younger age groups, with females >45 years demonstrating the poorest outcome scores. This data can be used to counsel patients preoperatively and to individualize care to optimize outcomes following hip arthroscopy for FAI.