title: Simultaneous Versus Staged Bilateral Hip Arthroscopy in the Treatment of Femoroacetabular Impingement.
abstract: To compare the clinical outcomes and complication rates of patients undergoing simultaneous versus staged bilateral hip arthroscopy for bilateral symptomatic femoroacetabular impingement (FAI).
  
  
  
  Between 2010 and 2013, a total of 1,800 hip arthroscopy cases were retrospectively reviewed for cases of simultaneous bilateral hip arthroscopy. All patients with minimum 1-year follow-up were included. This group was matched 1:2 for age, sex, and alpha angle, to a control group of patients who underwent staged, bilateral procedures. Patient-reported outcome scores, including the Modified Harris Hip Score (mHHS), the Hip Outcome Score-Activity of Daily Living (HOS-ADL), and the Hip Outcome Score-Sport-Specific Subscale (HOS-SSS) were obtained preoperatively at 6 months and 1 and 2 years postoperatively.
  
  
  
  Eighty-one patients (162 hips) were identified who underwent bilateral hip arthroscopy for symptomatic FAI. Twelve patients (24 hips) who underwent simultaneous bilateral arthroscopy with minimum 1-year follow-up were compared with a matched cohort of 24 patients (48 hips) who underwent staged bilateral procedures. Mean preoperative alpha angle was 65.3° ± 9.6° in the simultaneous group and 65.9° ± 11.2° in the staged group (P = .6). At a mean follow-up of 17.8 months (range, 12 to 33 months), there were comparable improvements in simultaneous versus staged patient-reported outcome scores (mHHS 90.8 ± 11 v 88.9 ± 12.5, P = .662; HOS-ADL 97.3 ± 3.8 v 92.6 ± 10.3, P = .057; HOS-SSS 93.3 ± 10.2 v 86.5 ± 16.6, P = .203). The mean single anesthetic traction time was 90.8 ± 21.9 minutes (sum of both hips) in the simultaneous group, compared with a combined 2-anesthetic traction time of 85.7 ± 27.2 minutes in the staged group (P = .579). There were no traction-related complications in either group. No patients in the simultaneous group required revision surgery, whereas 1 patient in the staged group required lysis of adhesions at 24 months postoperatively.
  
  
  
  In a small sample, simultaneous bilateral hip arthroscopy is shown to be safe and effective, resulting in similar improvements in patient-reported outcomes at 1-year follow-up compared with staged bilateral procedures.
  
  
  
  Level III, case-control study.
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.. Electronic address: DegenR@hss.edu.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: Degen
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Danyal H
authors.initials: DH
authors.lastname: Nawabi
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Kara G
authors.initials: KG
authors.lastname: Fields
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: C Sally
authors.initials: CS
authors.lastname: Wentzel
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Bryan T
authors.initials: BT
authors.lastname: Kelly
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Struan H
authors.initials: SH
authors.lastname: Coleman
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D057925:Femoracetabular Impingement / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071066:Patient Reported Outcome Measures; D012189:Retrospective Studies; D055815:Young Adult