Global Acetabular Retroversion Is Not Associated With Differences in Outcomes After Primary Hip Arthroscopy Among Patients With Femoroacetabular Impingement Syndrome: A Matched Cohort Study With Minimum 5-Year Follow-Up

Purpose The purpose of this study was to compare hip survivorship and patient-reported outcome measures (PROMs) after primary hip arthroscopy at five-year follow-up between femoroacetabular impingement syndrome (FAIS) patients with radiographic signs of global acetabular retroversion versus those without. Methods A retrospective matched-cohort study was conducted using a single-surgeon hip arthroscopy database. Patients were included if they underwent primary hip arthroscopy for treatment of FAIS, had preoperative hip X-rays, and had minimum five-year follow-up. Global retroversion was defined as the presence of ischial spine sign, posterior wall sign, and crossover sign on anteroposterior (AP) view. FAIS patients with global retroversion were matched 1:1 on age, sex, and body mass index (BMI) to FAIS controls. The modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) were administered preoperatively and at follow-up. Hip survivorship and PROMs were compared between the two groups using the paired t-test, Wilcoxon signed rank test, and/or Cochran-Mantel-Haenszel test as appropriate. P-values <0.05 were considered significant. Results Thirty-eight patients with global retroversion (mean age 40.6±10.8 years, 60.5% female) were matched to 38 controls (mean age 41.3±13.6 years, 60.5% female). Reoperation rates were the same in both groups (5.3%). On average, both groups reported significant pre-to-postoperative improvement in mHHS (p<0.001) and NAHS (p<0.001), and there was no significant inter-group differences in the change in mHHS (p=0.86) or NAHS (p=0.90). Achievement rates for the patient acceptable symptom state (PASS) on the mHHS were higher among males compared to females (p=0.04) in both the global retroversion group (93.3% vs. 73.9) and the control group (93.3% vs. 73.9%). Conclusion FAIS patients with and without global acetabular retroversion had no significant difference in outcomes after primary hip arthroscopy at minimum five-year minimum follow-up.