EP8.81 Recovery Trajectories of Patients Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A 15 Year Latent Class Analysis

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ID: 330924
2026
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Abstract
Abstract Background Cross-sectional outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) may obscure the dynamic course of postoperative recovery following primary hip arthroscopy. Purpose To identify distinct long-term recovery trajectories following hip arthroscopy for FAIS using 15-year longitudinal patient-reported outcomes. Methods A prospectively collected cohort of 214 hips (≥18 years) undergoing primary hip arthroscopy for FAIS at a single academic center was analyzed. Modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS) were collected at nine timepoints from baseline to 15 years. Latent class mixed modeling (LCMM) with a piecewise linear spline (knots at 0.5 and 5 years) evaluated 2–4 class solutions; a 3-class model was selected based on lowest Bayesian information criterion. Multinomial logistic regression assessed predictors of class membership (age, sex, body mass index (BMI)). Sensitivity analyses using NAHS, alternative knot placement, and 10-year censoring confirmed robustness. Distribution-based minimal clinically important difference (MCID) was calculated, and achievement, revision rates, and conversion to total hip arthroplasty (THA) were reported by class. Results Three trajectory classes were identified: Excellent Response (n=148, 69.2%), Limited Response (n=43, 20.1%), and Rapid Decline (n=23, 10.7%). The Excellent group demonstrated rapid improvement (mHHS 91.9±7.6 at 1 year; 93.8±8.5 at 10 years). The Limited group showed delayed improvement, reaching 58.2±12.9 at 1 year and plateauing at 77.0±15.8 at 10 years. The Rapid Decline group improved early (83.9±10.1 at 1 year) but declined to 49.8±22.9 by 10 years. Older age predicted Limited (OR 1.05/year, p=0.004) and Rapid Decline (OR 1.06/year, p=0.002). Higher BMI showed a dose-dependent association (Limited: OR 1.16, p=0.001; Rapid Decline: OR 1.30, p<0.001). Male sex was protective (Limited: OR 0.11; Rapid Decline: OR 0.16; both p≤0.002). Radiographic measures (alpha angle, LCEA) did not differ between groups. THA conversion was highest in the Limited group (14%, mean 6.7 years). Conclusion Three distinct long-term recovery trajectories exist following hip arthroscopy for FAIS. While most patients achieve durable improvement, approximately 10% experience late decline after early gains. Older age, higher BMI, and female sex predict less favorable trajectories. These findings enable improved risk stratification and highlight recovery patterns not captured in cross-sectional analyses.
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Authors Amanda Avila, BS Jade Refuerzo, Ekenedilichukwu Nwakoby, Ariana Lott, BS Dani Bregman, Thomas J. Youm
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.460
URL
https://doi.org/10.1093/jhps/hnag043.460
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