Abstract
Objective. To evaluate 12-month patient-reported outcomes after hip arthroscopy for femoroacetabular impingement (FAI) and to assess whether femoroplasty quality, implant type, and MRI-assessed capsular integrity are associated with outcomes.
Methods. This retrospective cohort study included 61 patients (64 hips/operations) who underwent hip arthroscopy for FAI. Patient-reported outcomes (iHOT-33, HOS-ADL, HOS-Sport) were collected preoperatively and at 12 months. Dunn 45° radiographs were obtained preoperatively and on postoperative day 1 to assess the alpha angle and offset ratio. Non-contrast 3T MRI
was performed at follow-up (mean 16.5±9.2 months) to evaluate capsular integrity (healed/partially healed/defect) and cystic/inflammatory soft-tissue changes at labral anchor fixation sites.
Results. Mean iHOT-33 improved from 53.0±18.9 to 80.3±11.6, HOS-ADL from 73.3±20.0 to 91.3±6.5, and HOS-Sport from 48.7±26.1 to 75.5±17.3 (all p<0.001). Complete capsular healing was observed in 32/64 (50.0%) hips/operations and was associated with greater improvement in iHOT-33 (p=0.001). Nonspheric femoroplasty was associated with a lower likelihood of achieving iHOT-33 MCID (p=0.012). MRI soft-tissue changes around labral anchors were observed in 22/54 (40.7%) labral repairs and were not associated with clinical improvement. In multivariable models, capsular integrity remained the only independent predictor of worse outcomes.
Conclusion. Hip arthroscopy for FAI resulted in clinically meaningful improvement at 12 months. MRI-assessed capsular integrity is a key factor associated with outcomes, whereas anchor-related MRI changes were common but not linked to clinical results; nonspheric femoroplasty may reduce the likelihood of clinically meaningful improvement.