Age-Associated Functional Outcomes Following Hip Arthroscopy in Females: Analysis with 5-Year Follow-Up

Purpose: The purpose of this study was to evaluate outcomes of hip arthroscopy for femoroacetabular impingement (FAI) in female patients at 5-year follow-up. The working hypothesis for this study was that increased age and body mass index (BMI) would be associated with poor outcomes. Methods: This study included all female patients 14 years and older who underwent primary hip arthroscopy for FAI with 5-year patient-reported outcome scores. Patients were separated into three age-based cohorts (< 30 years old, 30 to 45 years old, and > 45 years old) for subsequent statistical analysis. This analysis included a comparison of patient demographic information, intraoperative pathology, and functional outcome scores (modified Harris Hip Score [mHHSJ and nonarthritic hip score [NAHS]). Statistically significant values were utilized in a regression-based analysis to determine predictors of 5-year outcomes in female patients. A p-value of< 0.05 was considered to be statistically significant. Results: Overall, 97 patients met the inclusion criteria, and there was no significant difference in patient demographics (other than age and BMI) or in intraoperative pathologies identified. There were no significant difference across the three groups for mHHS and NAHS at baseline (p > 0.05). At baseline, there were no statistically significant differences between groups for NAHS scores, however < 30-year-old and 30- to 45-year-old cohorts had superior final NAHS scores relative to the > 45-year-old cohort (p = 0.005). At 5-year follow-up, the NAHS scores were significantly better for patients under 30 and 30 to 45 year olds relative to patients over 45 (84.2 [+ or -]15.1 vs. 86.7 [+ or -] 11.0 vs. 71.9 [+ or -] 26.8, respectively; p = 0.005). Overall, 88 patients (91%) met the minimal clinically important difference (MCID), and 60 patients (62%) achieved the patient acceptable symptomatic state (PASS). Baseline mHHS and BMI were shown to be statistically significant predictors of achieving MCID at 5 years in multivariate analysis (p < 0.001). Conclusion: The results of this study suggest that women generally have good-to-excellent outcomes following hip arthroscopy, although females older than 45 may have inferior outcomes relative to younger patients, and BMI and baseline mHHS may be utilized to predict long-term improvement.