title: Function and osteoarthritis progression after arthroscopic treatment of femoro-acetabular impingement: a prospective study after a mean follow-up of 4.6 (4.2-5.5) years.
abstract: BACKGROUND
  Outcomes after arthroscopic femoro-acetabular impingement (FAI) surgery are promising in the short-term but have rarely been evaluated in the mid-term (e.g., about 5 years). Here, our objectives were to obtain mid-term data on functional and radiographic outcomes, to identify prognostic factors, and to determine the mid-term rate of arthroplasty revision with the associated risk factors.
  
  
  OBJECTIVE
  We hypothesized that the results of arthroscopic FAI surgery were sustained over time.
  
  
  METHODS
  We conducted a prospective multi-surgeon study of 53 Tönnis grade 0 or 1 hips treated arthroscopically for symptomatic FAI (23 cam, 10 pincer, and 20 mixed deformities). We obtained short-term (10 months) and mid-term (4.6 years) data on the functional outcome (WOMAC and satisfaction scores), proportion of patients without revision arthroplasty, and development of osteoarthritis (graded using the Tönnis classification).
  
  
  RESULTS
  In the patients without revision arthroplasty, the WOMAC score improved significantly (P<0.01) from baseline (61.4 ± 15.6) to 10 months (84.2 ± 15.6) and last follow-up (85.2 ± 15.5) but remained unchanged between the two postoperative time points, confirming the stability of the results. The proportion of satisfied patients was 79% after 10 months and 68% (36/53) at last follow-up (NS). Osteoarthritis developed in 13/35 (37%) hips for which radiographs were obtained at last follow-up. At last follow-up, 46/53 hips (87%; 95%CI, 78-96) did not required revision surgery; arthroplasty was required in the 7 remaining hips. The main prognostic factor was the preoperative osteoarthritis Tönnis grade: at last follow-up, compared to Tönnis grade 0 hips, Tönnis grade 1 hips had lower WOMAC scores (77 vs. 88), lower satisfaction rates (50% versus 77%), a higher rate of osteoarthritis progression (57% versus 24%), and a higher rate of arthroplasty (33.3% versus 2.9%).
  
  
  CONCLUSIONS
  Our results are consistent with published data. The outcomes of arthroscopic FAI surgery are sustained over time and the preoperative osteoarthritis status is the main predictor of mid-term outcomes.
  
  
  METHODS
  IV, prospective cohort study.
authors.affiliation: Service d'orthopédie-traumatologie, CHU Hôpital Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes, France. Electronic address: thomas.gicquel2@chu-rennes.fr.
authors.forename: T
authors.initials: T
authors.lastname: Gicquel
authors.affiliation: Nouvelles Cliniques Nantaises, 4, rue Tabarly, 44277 Nantes, France.
authors.forename: J-E
authors.initials: JE
authors.lastname: Gédouin
authors.affiliation: Centre de chirurgie de la hanche, Médipôle Garonne, 45, rue de Gironis, 31100 Toulouse, France; Service d'Orthopédie C, Hôpital Salengro, CHRU de Lille, rue Émile-Laine, 59000 Lille, France.
authors.forename: N
authors.initials: N
authors.lastname: Krantz
authors.affiliation: Centre de chirurgie de la hanche, Médipôle Garonne, 45, rue de Gironis, 31100 Toulouse, France; Service d'Orthopédie C, Hôpital Salengro, CHRU de Lille, rue Émile-Laine, 59000 Lille, France.
authors.forename: O
authors.initials: O
authors.lastname: May
authors.affiliation: Service d'Orthopédie-Traumatologie Pédiatrique, Hôpital de Hautepierre, CHRU de Strasbourg, 1, avenue Molière, 67098 Strasbourg Cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Gicquel
authors.affiliation: LyonOrthoClinic, 29B, avenue des Sources, 69009 Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Bonin
mesh_terms: D000328:Adult; D001182:Arthroscopy; D018450:Disease Progression; D005260:Female; D057925:Femoracetabular Impingement / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000145:classification / Q000150:complications* / Q000209:etiology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012086:Reoperation
keywords: Cartilage; Femoro-acetabular impingement; Hip; Labrum; Osteoarthritis