Danish Hip Arthroscopy Registry: predictors of outcomes in patients with femoroacetabular impingement

Key points

1. 01Drawn from 2054 hip arthroscopy procedures in the Danish Hip Arthroscopy Registry between January 2012 and May 2015.
2. 02All patient-reported scores (HAGOS sub-scales, EQ-5D, HSAS, NRS pain) improved significantly in every age group at follow up.
3. 03Patients in both older age groups (25 to 39 and over 40) had poorer outcomes than those under 25 at one and two year follow up.
4. 04Major acetabular cartilage injuries were tied to worse results than minor injuries in almost all outcome scores; femoral cartilage injury showed no significant effect.
5. 05Female patients had poorer outcomes in two HAGOS sub-scales (pain, ADL) at one year and in HSAS at two years.

How it was conducted

Design

Observational analysis of prospective hip arthroscopy registry (DHAR) data

Participants

2054 FAI procedures recorded between January 2012 and May 2015; 53% in female patients

Groups

Age groups under 25, 25 to 39, and over 40 years; cartilage injuries graded by ICRS (femoral) and Becks (acetabular)

Outcomes

Patient-reported outcomes: HAGOS sub-scales, EQ-5D, HSAS, and NRS pain at one and two year follow up

What they found

• 53% of the 2054 procedures were in female patients.
• All HAGOS sub-scales, EQ-5D, HSAS and NRS pain scores improved significantly in all age groups at follow up.
• Both older age groups had poorer outcomes than the under 25 group at one and two year follow up; the oldest group did worse than the middle group in HAGOS PA and QoL, HSAS and EQ-5D at two years.
• Patients with major acetabular cartilage injuries had poorer outcomes than those with minor injuries in almost all scores; femoral cartilage injury showed no significant change at follow up.
• Female patients had poorer outcomes than males in HAGOS pain and ADL at one year and in HSAS at two years.

Limitations

• This is a conference abstract, so detailed effect sizes, confidence intervals and p-values are not reported.
• Registry-based observational design shows associations, not cause and effect, and cannot rule out confounding.
• Follow up extends only to two years, leaving longer-term durability unknown.
• Predictors were specific to selected score subscales, so the practical size of each effect is unclear.

Why it matters

For patients

If you are over 25, female, or have significant cartilage damage in the hip socket, you may still improve after FAI hip arthroscopy but might expect somewhat less benefit.

For clinicians

Use age over 25, major acetabular cartilage damage, and female sex as prognostic factors to set expectations when counseling FAI surgery candidates.

For readers

A very large registry confirms hip arthroscopy helps FAI symptoms overall while flagging who tends to gain less, useful context for prognosis discussions.