Borderline Dysplastic Female Patients With Painful Internal Snapping Improve Clinical Outcomes At Minimum Two-Year Follow-Up Following Hip Arthroscopy With Femoroplasty, Labral Repair, Iliopsoas Fractional Lengthening And Capsular Plication: A Propensity-Matched Controlled Comparison.

PURPOSES To report minimum two-year follow-up patient-reported outcome scores (PROs) in borderline dysplastic female patients who underwent primary hip arthroscopy with femoroplasty, labral repair, iliopsoas fractional lengthening, and plication of the capsule (FLIP procedure) for cam-type femoroacetabular impingement syndrome (FAIS), labral tear, and painful internal snapping. Secondary, to compare these PROs to a propensity-matched borderline dysplastic control group without painful internal snapping. METHODS Data was retrospectively reviewed for patients who underwent primary hip arthroscopy for cam-type FAIS and labral tear between September 2008 and May 2017. Females with borderline dysplasia (lateral center-edge angle of ≥ 18° to ≤ 25°) and painful internal snapping, who underwent the FLIP procedure, with minimum two-year PROs for modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, patient satisfaction, and visual analog scale (VAS) for pain were included. The group was matched 1:1 to a control group without painful internal snapping for age, sex, body-mass index (BMI), and surgical procedures. The minimal clinically important difference (MCID) was calculated. P-value was set at .05. RESULTS Seventy-four hips were included. The mean was 26.82 ± 10.49 years and 23.62 ± 4.56 kg/m2 for age and BMI, respectively. Improvement was reported for all PROs and VAS (P< .0001). Twenty-nine patients were matched. At minimum two-year follow-up, the FLIP procedure demonstrated comparable improvement in PROs and rate of achievement of MCID to the control group. CONCLUSION Following primary hip arthroscopy and FLIP procedure, females with borderline dysplasia and painful internal snapping demonstrated significant improvement in PROs at minimum two-year follow-up. When compared to a propensity-matched control group without painful internal snapping, the improvement between groups was comparable.