Spinopelvic Parameters Do Not Influence Outcomes Following Primary Hip Arthroscopy for the Treatment of Femoroacetabular Impingement Syndrome

Abstract

Purpose: To evaluate the influence of spinopelvic parameters on short-term postoperative patient-reported outcomes (PROs) following primary hip arthroscopy for the treatment of femoroacetabular impingement syndrome (FAIS). Methods: Patients undergoing primary hip arthroscopy between January 2012 and December 2015 were retrospectively reviewed. Hip Outcome Score – Activities of Daily Living, Hip Outcome Score – Sports-Specific Subscale, modified Harris Hip Score, International Hip Outcome Tool-12, and visual analog scale pain were recorded preoperatively and at final follow-up. Lumbar lordosis (LL), pelvic tilt (PT), sacral slope, and pelvic incidence (PI) were measured on lateral radiographs in standing position. Patients were split into subgroups for individual analyses based on previous literature cutoffs: |PI-LL|> or or 65°. PROs and rate of achievement of patient acceptable symptom state (PASS) were compared between subgroups at final follow-up. Results: Sixty-one patients who underwent unilateral hip arthroscopy were included in the analysis, and 66% of patients were female. Mean patient age was 37.6 ± 11.3 years, whereas mean body mass index was 25.0 ± 5.7. Mean follow-up time was 27.6 ± 9.0 months. No significant difference in preoperative nor postoperative PROs were appreciated in patients with spinopelvic mismatch (|PI-LL| >10°) versus those without, whereas patients with mismatch achieved PASS according to the modified Harris Hip Score (P = .037) and International Hip Outcome Tool-12 (P = .030) at greater rates. When we compared patients with a PT ≥20° versus PT 65°, no significant differences in 2-year PROs or rates of PASS achievement for any PRO were appreciated (P > .05 for all). Conclusions: In this study, spinopelvic parameters and traditional measures of sagittal imbalance did not influence PROs in patients undergoing primary hip arthroscopy for FAIS. Patients with sagittal imbalance (|PI-LL|> 10° or PT >20°) achieved a greater rate of PASS. Level of Evidence: IV; Prognostic case series.