Hip Arthroscopy in Military Personnel Produces Outcomes Similar to Civilian Series

Abstract/Description/Artist Statement

Introduction

Hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has shown excellent outcomes in civilian populations, but earlier military studies have reported higher military separation rates and limited improvement versus physical therapy. Given advances in modern techniques, this study evaluated clinical and return-to-duty outcomes for active-duty U.S. military personnel undergoing surgical management of FAIS by a single surgeon.

Methods

Active-duty patients who underwent primary hip arthroscopy over a four-year period were identified. Demographic, clinical, operative, and radiographic data (LCEA, ACEA, alpha angle) were collected. Patient-reported outcome measures (PROMs) were collected pre- and postoperatively, along with satisfaction and military disposition. Cohort-specific minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were calculated.

Results

One-hundred nine patients (123 hips) completed final follow-up (81%) at a mean 46 ± 11 months post-op. Acetabuloplasty and capsular repair was performed in 100% of hips, while femoroplasty and labral repair in 98%. Acceptable postoperative radiographic parameters were achieved in 96%. Five patients required subsequent total hip arthroplasty and two underwent revision arthroscopy. Among surviving hips significant findings include, mHHS improved from 61 to 81 and SANE from 47 to 69, while VAS pain decreased modestly from 3.8 to 3.2 (p=0.02). MCID and PASS for mHHS were achieved in 75% and 72%, respectively, with an 89% patient satisfaction rate. Excluding THA patients, return-to-duty was 73%, with 28% remaining on active duty at a mean 42 ± 10 months.

Conclusion

These findings suggest modern arthroscopic management of FAIS can provide favorable outcomes in appropriately selected military personel.

Presenting Author Name/s

Emilio Ihde

Faculty Advisor/Mentor

Dr. George Balazs

Faculty Advisor/Mentor Email

gcbalazs@gmail.com

Faculty Advisor/Mentor Department

NMCP Department of Orthopedic Surgery

College/School Affiliation

Eastern Virginia School of Medicine

Student Level Group

Medical

Presentation Type

Oral Presentation

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Hip Arthroscopy in Military Personnel Produces Outcomes Similar to Civilian Series

Introduction

Hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has shown excellent outcomes in civilian populations, but earlier military studies have reported higher military separation rates and limited improvement versus physical therapy. Given advances in modern techniques, this study evaluated clinical and return-to-duty outcomes for active-duty U.S. military personnel undergoing surgical management of FAIS by a single surgeon.

Methods

Active-duty patients who underwent primary hip arthroscopy over a four-year period were identified. Demographic, clinical, operative, and radiographic data (LCEA, ACEA, alpha angle) were collected. Patient-reported outcome measures (PROMs) were collected pre- and postoperatively, along with satisfaction and military disposition. Cohort-specific minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were calculated.

Results

One-hundred nine patients (123 hips) completed final follow-up (81%) at a mean 46 ± 11 months post-op. Acetabuloplasty and capsular repair was performed in 100% of hips, while femoroplasty and labral repair in 98%. Acceptable postoperative radiographic parameters were achieved in 96%. Five patients required subsequent total hip arthroplasty and two underwent revision arthroscopy. Among surviving hips significant findings include, mHHS improved from 61 to 81 and SANE from 47 to 69, while VAS pain decreased modestly from 3.8 to 3.2 (p=0.02). MCID and PASS for mHHS were achieved in 75% and 72%, respectively, with an 89% patient satisfaction rate. Excluding THA patients, return-to-duty was 73%, with 28% remaining on active duty at a mean 42 ± 10 months.

Conclusion

These findings suggest modern arthroscopic management of FAIS can provide favorable outcomes in appropriately selected military personel.