Arthroscopy - 2026-05-06 - Journal Article
Hip Arthroscopy in Femoroacetabular Impingement Syndrome With Versus Without Low Back Pain and Lumbar Spine Pathology Shows Comparable Outcomes at Minimum 5-Year Follow-Up.
Niu X, Xie Z
Topics
Key Takeaway
Hip arthroscopy for FAIS with concomitant low back pain and/or lumbar spine pathology achieves equivalent Harris Hip Score improvement, PASS rates (~89%), and reoperation-free survivorship compared to isolated FAIS at minimum 5-year follow-up.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This retrospective comparative study stratified Asian FAIS patients undergoing primary hip arthroscopy with labral repair into three groups—LBP only, LBP plus lumbar spine pathology (LSP), and neither—to determine whether spinal comorbidity affects 5-year outcomes. HHS and VAS improved significantly from baseline in all three groups (P<.0001), with no between-group differences preoperatively or at final follow-up (P≥.057). PASS achievement was comparable across groups (89.1%, 88.1%, 90.1%; P=.86), as were revision arthroscopy and THA conversion rates (P=.45).
Key Limitation
The total sample size per group is not explicitly reported, limiting power calculations and the ability to detect clinically meaningful between-group differences in reoperation rates.
Original Abstract
PURPOSE
To evaluate the patient-reported outcome measures (PROMs) of hip arthroscopy (HA) in patients with concomitant low back pain and lumbar spine pathology (LSP) compared with those without back concerns at a minimum of 5 year follow-up and determine the prevalence of low back pain (LBP) and LSP in Asian patients with femoroacetabular impingement syndrome (FAIS).
METHODS
Patients with FAIS, who underwent primary HA for FAIS with labral repair by a single surgeon between July 2017 and October 2019 with minimum 5-year follow-up, were identified. Patients were placed into 3 groups based on presence of preoperative LBP and LSP. These groups included: group LBP (with LBP), group Both (with LBP and LSP), and group None (neither diagnosis). The presence of concomitant LSP was identified using preoperative imaging with a pathologic lumbar spine diagnosis. All patients included in the study were asked to complete the Harris Hip Score (HHS) and Visual Analog Scale (VAS). All patients enrolled in the study were asked to fill out this survey preoperatively, at 3 months postoperatively, and latest follow-up. Satisfaction ratings were collected. Patient-reported outcomes (PROs) were compared between groups, postoperative with preoperative, along with revision arthroscopy, and conversion to total hip arthroplasty (THA).
RESULTS
The groups were similar in age (46.2 ± 14.4 years, 46.0 ± 15.5 vs 43.9 ± 13.8, P = .16), sex (55.4% female, 58.2% vs 55.4%,P = .91), and body mass index (23.4 ± 2.2 kg/m 2 , 23.6 ± 2.5 vs 23.1 ± 2.2, P = .93). Comparing HHS and VAS between groups, no significant differences were observed preoperatively and at 5-year follow-up (P ≥ 0.057). Postoperative PROs significantly improved compared with preoperative PROs in all groups at 5-year follow-up (P < .0001). The LBP, Both, and None groups showed comparable rates of any patient acceptable symptomatic state (PASS) (89.1%, 88.1% vs 90.1%, P = .86) at 5-year follow-up. No significant differences in the rates of revision or THA conversion were identified between groups (P = .45). The prevalence of LBP and LSP was 28.9% and 11.5% in the cohort, respectively.
CONCLUSIONS
The patients with LBP and/or LSP undergoing HA achieved comparable PROs, achievement of PASS, and reoperation-free survivorship to patients with isolated FAIS at minimum 5-year follow-up. The prevalence of LBP and LSP was 28.9% and 11.5% in Asian patients with FAIS, respectively.
LEVEL OF EVIDENCE
Level III, retrospective therapeutic comparative case series.