Outcomes 2 to 5 years following hip arthroscopy for femoroacetabular impingement in the patient aged 11 to 16 years

Purpose: The purpose of this study was to evaluate clinical outcomes after treatment for femoroacetabular impingement in the pediatric and adolescent population with a minimum of 2 years' follow-up.

Methods: Prospectively collected data on 60 consecutive pediatric and adolescent patients (65 hips), aged 16 years or younger, who underwent hip arthroscopy were retrospectively analyzed. Patients were excluded if they had previous surgery on the hip and if they presented a center-edge angle below 25°.

Results: The mean age at the time of surgery was 15 years (range, 11 to 16 years), and 31% of patients were boys and 69% were girls. The femoral physis was open in 10% of patients, partially closed in 19%, and closed in 71%. Cam impingement was found in 10% of cases, pincer impingement in 15%, and mixed type in 75%. The mean center-edge angle was 36° (95% confidence interval [CI], 34° to 38°), and the mean alpha angle was 64° (95% CI, 60° to 69°). There was a significant association between age and alpha angle (r = 0.324, P = .02). After the index procedure, 8 patients (all girls) needed second-look diagnostic arthroscopies because of intra-articular adhesions. At a mean follow-up of 3 years (range, 2 to 5 years) with 91% follow-up, the modified Harris Hip Score increased from a mean of 57 (95% CI, 51 to 62) to a mean of 91 (95% CI, 88 to 94) (P < .001). The median rating for patient satisfaction with outcome was 10 (range, 5 to 10).

Conclusions: Hip arthroscopy in the pediatric and adolescent population is a safe procedure, with excellent clinical outcomes at 2 to 5 years. In this study there was an association between alpha angle and age. Clinical scores showed a significant improvement after surgery; however, 13% of patients did require a second procedure for capsulolabral adhesions.

Level of evidence: Level IV, therapeutic case series.