Risk Factors for Bilateral Femoroacetabular Impingement Syndrome Requiring Surgery

Purpose: To identify the risk factors for contralateral surgery in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Methods: Patients who underwent unilateral surgery were compared with those who underwent staged bilateral surgery to identify risk factors associated with bilateral surgery. Variables examined included demographics, comorbidities, and radiographic features. Binary logistic regression was used to identify predictors of bilateral FAIS. Results: A total of 694 patients with an average age of 34.0 ± 13.1 years met were included in the analysis. Overall, 109 patients (15.3%) had staged bilateral hip arthroscopy for FAIS. Risk factors associated for bilateral FAIS requiring surgery were decreased age and lower Charlson Comorbidity Index (CCI). Compared with patients aged <25 years, those aged 25 to 34 years (odds ratio [OR], 0.5; P = 0.031), 35 to 44 years (OR, 0.5; P = 0.034), and ≥45 years (OR, 0.3; P = 0.002) had lower odds of bilateral labral tear. In addition, patients with a CCI <2 were three times more likely to require bilateral FAIS surgery (OR, 3.4; P = 0.044). None of the radiographic parameters predicted bilateral labral tears. Conclusion: Patients younger than 25 years and those with a CCI <2 had markedly increased rates of bilateral FAIS necessitating surgery compared with older patients. This study may be of value in preoperative counseling.