Arthroscopy - 2026-09-08 - Journal Article
Recovery Curves After Hip Arthroscopy for Femoroacetabular Impingement Are Slower for Patients With Severe Ligamentous Laxity: A Propensity-Matched Study.
Patel DH, Quesada-Jimenez R, Ko W, Reyes A, Kahana-Rojkind AH, Kuhns BD, Domb BG
Topics
Key Takeaway
Hip arthroscopy for FAI in patients with Beighton score 8-9 yields 52.2% PASS achievement at 3 months versus 76.0% in controls, but outcomes normalize by mid-term follow-up.
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Summary
This study compared patient-reported outcome recovery trajectories after hip arthroscopy for FAI between propensity-matched GLL patients (Beighton ≥4) and non-GLL controls, with a subanalysis isolating high Beighton (HB, score 8-9) patients. The GLL versus control comparison showed no differences in mHHS, NAHS, iHOT-12, HOS-SS, or VAS at any time point, with comparable MCID and PASS achievement rates. The HB subgroup demonstrated significantly higher pain at 3 months (2.83 vs 1.53, P=.02) and 1 year (2.95 vs 1.75, P=.03) and lower 3-month PASS rates (52.2% vs 76.0%, P=.02), converging with controls at mid-term.
Key Limitation
The subanalysis comparing HB (score 8-9) to non-GLL controls is underpowered relative to the primary matched cohort, limiting confidence in the subgroup-specific effect sizes and PASS threshold differences.
Original Abstract
PURPOSE
To evaluate the patient-reported outcome recovery trajectories of generalized ligamentous laxity (GLL) patients undergoing hip arthroplasty for femoroacetabular impingement and labral tears from preoperative to short- to mid-term follow-up and to compare these results to a propensity-matched control group without GLL.
METHODS
Patients from a single-institution database who underwent primary hip arthroplasty for femoroacetabular impingement syndrome and labral tears between October 2012 and August 2022 were retrospectively reviewed. Included patients had preoperative and minimum 2-year follow-up patient-reported outcomes, including modified Harris Hip Score, Nonarthritic Hip Score, International Hip Outcome Tool-12, Hip Outcome Score-Sport Scale, and Visual Analogue Scale for pain. Patients with Beighton score ≥4 were propensity-matched to patients with Beighton score <4. A subanalysis was conducted comparing individuals with high Beighton (HB) scores of 8 or 9 to a non-GLL control group. Rates of achieving clinically relevant outcome thresholds including the patient acceptable symptomatic state (PASS) and minimum clinically important difference were collected.
RESULTS
Three hundred forty-five GLL patients were successfully matched to 345 control patients. There were no differences in patient-reported outcomes at any time point. There were no differences in reoperation rates and a high percentage of minimum clinically important difference and PASS threshold achievement across both groups. Subanalysis comparing the HB and non-GLL groups showed a slower recovery for the HB group, with significantly higher pain scores at the 3-month (2.83 ± 2.15 vs 1.53 ± 1.37; P = .02) and 1-year (2.95 ± 1.99 vs 1.75 ± 2.50; P = .03) time points but reaching similar long-term outcomes. Patients in the HB group also had lower rates of PASS threshold achievement at 3 months (52.2% vs 76.0%; P = .02) compared with the control group but had comparable long-term outcomes.
CONCLUSIONS
Hip arthroplasty in patients with GLL yielded significant improvements at short- to mid-term follow-up, with a recovery trajectory comparable to that of patients without GLL. However, patients with higher Beighton scores of 8 or 9 exhibited a slower recovery curve with higher pain levels and lower rates of PASS threshold achievement, which then normalized in the mid-term.
LEVEL OF EVIDENCE
Level III, retrospective comparative control study.