Impact of spine pathology on outcomes following hip surgery for FAIS in HSS

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Created On: 13/03/2023

This study aimed to investigate if spine pathology influences outcomes following arthroscopy of hip for femoroacetabular impingement syndrome (FAIS) in context of hip-spine syndrome (HSS).

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Key take away

For treatment of femoroacetabular impingement syndrome, hip spine syndrome negatively impacts arthroscopic outcomes.

Background

This study aimed to investigate if spine pathology influences outcomes following arthroscopy of hip for femoroacetabular impingement syndrome (FAIS) in context of hip-spine syndrome (HSS).

Method

Databases such as Cochrane and PubMed were explored. In the presence of concurrent spinal pathology and hip arthroscopy for FAIS, primary research publications analyzing patient-reported outcomes (PRO) were taken into consideration.

Result

In this systematic review, 12 studies fulfilled the inclusion criteria. Out of 2109 FAIS subjects with hip arthroscopic surgery, 591 also had concurrent spine pathology.

In hip-spine group, baseline PROs were as follows: non-arthritic Hip Score [NAHS]: 42.2-51.5 versus 68.2-75.2, four studies; Modified Harris Hip Score [mHHS]: 39.8-65.29 versus 56.9-78.8, eight studies; Hip Outcome Score for Activities of Daily Living [HOS-ADL]: 45.9-71.1 versus 49.3-89.51, nine studies; Hip Outcome Score for Sports [HOS-Sport]: 2.8–49.6 vs 50.6–73.1, three studies; visual analog scale [VAS] Pain: 6.43–6.56 vs 1.18–3.60, three studies; VAS Satisfaction: 7.18-7.46 range at follow-up, two studies, and international hip outcome tool-33 [iHOT-12]: 38.0 vs 66.0, one study.

Baseline PROs in the control group were as follows: mHHS: 39.3–64.9 vs 70.2–92.6, six studies; NAHS: 42.8–54.2 versus 74.0–87.1, four studies; HOS-ADL: 59.0–76.4 versus 75.4–97.1, four studies; VAS Satisfaction: 7.74–8.22 range at follow up, two studies; HOS-Sport: 38.1–55.1 versus 60.9–93.9, three studies; iHOT-12: 43.4 versus 89.8, one study; and VAS Pain: 6.18–6.22 versus 1.82–3.44, two studies.

Hip-spine cohorts (44.1-86.7, 4 trials) reached minimal clinically meaningful difference threshold rates that were considerably reduced than control cohorts (79.4-88.2%, 4 trials) in 3 studies. In one trial, patient-acceptable symptomatic state threshold rates were considerably reduced in the hip-spine (42-63.5, 3 trials) cohorts than in the control (58.8-81.0, 3 trials). Reoperation and complication rates did not differ statistically between groups.