• David R Maldonado, Samantha C Diulus, Jacob Shapira, Philip J Rosinsky, Cynthia Kyin, Hari K Ankem, Ajay C Lall, and Benjamin G Domb.
• Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, USA.
• Am J Sports Med. 2021 Jan 1; 49 (1): 55-65.

BackgroundImprovement in patient-reported outcomes (PROs) has been reported in the short term after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear in the setting of acetabular overcoverage. Yet, there is a paucity of information in the literature on midterm PROs.PurposeTo (1) report minimum 5-year PROs in patients who underwent primary hip arthroscopy for FAIS and acetabular labral tears in the context of acetabular overcoverage and (2) compare outcomes with those of a propensity-matched control group without acetabular overcoverage.Study DesignCohort study; Level of evidence, 3.MethodsData were prospectively collected and retrospectively analyzed on all patients who underwent hip arthroscopy for FAIS and labral tears between February 2008 and November 2013. Inclusion criteria were lateral center-edge angle >40° and minimum 5-year follow-up for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and the Hip Outcome Score-Sports-Specific Subscale (HOS-SSS). Exclusion criteria were previous ipsilateral hip surgery or conditions, active workers' compensation claims, or lack of minimum 5-year outcomes. A 1:1 propensity-matched comparison was made between the study group and a control group without acetabular overcoverage (lateral center-edge angle, 25°-40°) based on age at surgery, sex, body mass index, Tönnis grade, laterality, and follow-up time. The minimal clinically important difference (MCID) was calculated for the mHHS, HOS-SSS, and NAHS. Secondary surgical procedures were recorded.ResultsA total of 54 patients satisfied the inclusion criteria for the study group, of whom 45 (83.3%; 45 hips) had a minimum 5-year follow-up and were matched without differences in age at surgery, sex, body mass index, or follow-up time. The study and control groups demonstrated significant and comparable improvements for the mHHS (mean ± SD Δ, 24.06 ± 24.19 vs 26.33 ± 17.27; P = .625), NAHS (Δ, 31.22 ± 25.31 vs 27.15 ± 17.61; P = .399), and HOS-SSS (Δ, 33.16 ± 34.73 vs 34.75 ± 26.15; P = .557). The rates for achieving the MCID were similar for the study and control groups for the mHHS (76.7% vs 84.2%; P = .399), HOS-SSS (79.1% vs 75.8%; P = .731), and NAHS (81.4% vs 84.2%; P = .738). Need for revision surgery was similar (P = .748). A lower conversion rate to total hip arthroplasty was reported for the study than for the control group (2.2% vs 15.6%; P = .026).ConclusionIn the context of FAIS, labral tears, and acetabular overcoverage, patients who underwent hip arthroscopy reported significant improvement in several PROs at minimum 5-year follow-up. Moreover, outcomes were comparable with those of a propensity-matched control group without acetabular overcoverage. Furthermore, the rate of achieving the MCID for the mHHS, HOS-SSS, and NAHS was similar between these groups.

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