Femoroacetabular Impingement in Adolescent Athletes: Outcomes of Arthroscopic Management

Abstract

Background: Adolescent athletes with symptomatic femoroacetabular impingement (FAI) may respond well to arthroscopic intervention.

Purpose: This study reports the outcomes of arthroscopic treatment for symptomatic FAI in adolescents.

Study design: Case series; Level of evidence, 4.

Methods: Included in this study were 104 consecutive athletes (116 hips) younger than 18 years who underwent arthroscopic correction of symptomatic FAI with a minimum 2-year follow-up. All patients were prospectively assessed with the modified Harris Hip Score (mHHS). Pincer lesions were defined by acetabular overcoverage or retroversion with an accompanying labral injury, and cam lesions were defined by loss of sphericity of the femoral head with associated acetabular articular failure.

Results: The average follow-up was 38 months (range, 24-120 months), and the average patient age was 16 years (range, 12-17 years), with 47 male and 57 female patients. There were 67 combined, 33 cam, and 16 pincer lesions. The average improvement on the mHHS was 25 points (average score: 69 preoperatively, 94 postoperatively), with 97% improved and 94% good and excellent results. Athletes returned to their sport after 100 procedures (86%). After 16 procedures, 5 patients were unable to return to sport, 6 chose not to, and 5 had completed their high school athletic careers. There were 2 complications, both transient pudendal nerve neurapraxias, that resolved within 2 weeks. Four patients underwent repeat arthroscopic surgery, and 1 underwent periacetabular osteotomy.

Conclusion: This study reports favorable outcomes of arthroscopic treatment of FAI among adolescent athletes. A high proportion improved, although only 87% actually returned to their sport. Return to sport may be influenced by factors other than just the success of the procedures.

Keywords: FAI; adolescents; hip arthroscopic surgery; outcomes.