Paper #72 - ISHA Annual Scientific Meeting 2016

Simultaneous Bilateral Hip Arthroscopy in Adolescent Athletes with Symptomatic Femoroacetabular Impingement

Mark O McConkey, MD, North Vancouver, British Columbia CANADA
Vivek Chadayammuri, BS, Aurora, CO UNITED STATES
Tigran Garabekyan, MD, North Hollywood, CA UNITED STATES
Stephanie Watson Mayer, MD, Aurora, CO UNITED STATES
Matthew J. Kraeutler, MD, Boulder, CO UNITED STATES
Cecilia Pascual-Garrido, MD, Boulder, CO UNITED STATES
Omer Mei-Dan, MD, Aurora, CO UNITED STATES

University of Colorado School of Medicine, Aurora, CO, UNITED STATES

FDA Status Not Applicable

Summary: Simultaneous bilateral hip arthroscopy under one anesthetic is a safe and reproducible procedure in adolescent athletes with femoroacetabular impingement.

Abstract:
Femoroacetabular impingement (FAI) represents one of the most commonly implicated conditions of chronic hip pain in the adolescent population. It has been shown that adult patients with bilateral symptomatic hips can expect good outcomes when treated with sequential FAI surgery or bilateral FAI surgery under the same anesthetic, with the latter option enabling a shorter postoperative recovery period and earlier return to pre-injury level of activity. The purpose of the present study was to evaluate the safety and efficacy of simultaneous bilateral hip arthroscopy for bilateral symptomatic FAI in adolescent athletes.

Prospective clinical data collected on each patient included: complications associated with the surgical procedure, re-operation rate, length of hospital stay, VAS score and analgesic use (postoperative days 1-10), and return to play time. Differences in iHOT-12 scores according to hip side (right or left) and time of postoperative follow-up (pre-operative, 6 weeks, 13 weeks, 6 months, 12 months, and 24 months) were evaluated using a 2 x 6 repeated measures analysis of variance (ANOVA) with post-hoc repeated-measures one-way ANOVA and Bonferroni-corrected paired t-tests.

The study cohort comprised 24 patients (36 hips), of which 12 patients underwent bilateral (simultaneous) hip arthroscopy (24 hips) and a case-matched control group of 12 patients underwent unilateral hip arthroscopy. No patients were lost to follow-up. A significant increase of 21.0 points in mean iHOT-12 score was observed between 6 and 13 week follow-up (61.8 vs 82.8, respectively; p = 0.003), and 6, 12, and 24-month follow-up (91.4, 95.1, and 96.6, respectively, p = 0.001). At all follow-up times, there were no significant differences in mean iHOT-12 scores or any other outcome measure between the bilateral and unilateral hip arthroscopy cohorts. Female patients tended to report lower mean iHOT-12 scores preoperatively compared to males but achieved a similar mean iHOT-12 score by 24-month follow-up.

Bilateral surgery under one anesthetic is a safe and reproducible procedure in adolescent athletes.