EP3.38 BMI More Than Pre- and Post-operative Radiologic Cam Morphology Predicts 10-Year Patient Reported Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome

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ID: 330949
2026
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Abstract
Abstract Background Radiographic morphology is central to diagnosis and surgical planning for femoroacetabular impingement syndrome (FAIS), but whether cam deformity severity, correction magnitude, residual morphology, or demographic factors best predicts long-term outcomes remains unclear. Hypothesis/Purpose To determine whether preoperative cam morphology, postoperative cam morphology, correction magnitude, or patient demographics best predicts 10-year patient-reported outcomes (PROs) after primary hip arthroscopy for FAIS. Methods Patients who underwent primary hip arthroscopy (HA) for FAIS (2011-2013) by a single surgeon, with a ≥10-year follow-up, were reviewed. PROs included the modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS). Radiographic variables (alpha angle, femoral head-neck (FHN) offset), were measured on AP and 45° Dunn views. Hierarchical regressions tested demographic covariates (age, sex, BMI, baseline PRO) and morphology (preoperative, postoperative, and overall change). Additional analyses assessed cam severity, residual morphology, MCID, and PASS. Results A total of 147 hips were included (mean age, 38.4 years; mean BMI, 24.6 kg/m2). At 10 years, MCID was achieved by 89.9% (mHHS) and 91.9% (NAHS), and PASS by 79.1% and 83.1%, respectively. Across all models, BMI most consistently predicted worse outcomes, associated with lower mHHS (β = -0.278, p = 0.003), NAHS (β = -0.340, p < 0.001), and smaller ΔmHHS/ΔNAHS (p ≤ 0.006). Among cam variables, only severe preoperative deformity on the 45° Dunn view (>83°) was independently associated with worse 10-year outcomes. Residual cam (>60° on AP or 45° Dunn) was not associated with 10-year mHHS or NAHS (all p>0.4). Morphologic measures added only modest incremental model fit (ΔR2 ≤ 0.076). Conclusion At long-term follow-up, BMI predicted 10-year PROs and achievement of MCID/PASS more strongly than radiographic cam morphology for FAIS patients following HA. While severe preoperative cam deformity demonstrated independent prognostic value, residual morphology and correction magnitude were not associated with outcomes after accounting for host factors.
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Authors Jade Refuerzo, Amanda Avila, Samy Shelbaya, Daniel James Kaplan, Thomas J. Youm
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.323
URL
https://doi.org/10.1093/jhps/hnag043.323
Keywords Keywords not found

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