This prospective registry-based case series from a single surgeon reports 10-year survivorship and patient-reported outcomes after arthroscopic correction of symptomatic FAI. The study specifically excluded patients with dysplasia (lateral center-edge angle <25°) or early OA (Tönnis grade >1) to define outcomes in a true FAI population.
The 10-year horizon is where most FAI arthroscopy literature had previously gone silent — short- and medium-term studies consistently showed benefit, but whether those gains held or patients eventually progressed to replacement was unknown.
This paper gives you two clear decision rules. First: do not offer arthroscopy to patients with Tönnis grade >1 or lateral center-edge angle <25°. Their 10-year survivorship drops to 80% even at grade 1, and joint space under 2 mm (cited from supporting literature) carries 86-89% conversion to total hip replacement. Second: at the time of arthroscopy, full-thickness femoral cartilage loss (Outerbridge grade 4) should prompt a frank conversation about arthroplasty. It carries an 11-fold increased odds of eventual conversion.
For the appropriately selected patient (no OA, no dysplasia, correctable bony morphology), you can quote them 91.6% survivorship and 90% satisfaction at a decade.
One nuance worth knowing: the UCLA activity score returned to baseline at 10 years despite sustained improvements in pain and function. This is an age effect, not a hip effect. Avoid using activity-composite scores like iHOT for long-term FAI follow-up, where natural aging will artificially depress the score.
This prospective registry-based case series from a single surgeon reports 10-year survivorship and patient-reported outcomes after arthroscopic correction of symptomatic FAI. The study specifically excluded patients with dysplasia (lateral center-edge angle <25°) or early OA (Tönnis grade >1) to define outcomes in a true FAI population.
The 10-year horizon is where most FAI arthroscopy literature had previously gone silent — short- and medium-term studies consistently showed benefit, but whether those gains held or patients eventually progressed to replacement was unknown.
This paper gives you two clear decision rules. First: do not offer arthroscopy to patients with Tönnis grade >1 or lateral center-edge angle <25°. Their 10-year survivorship drops to 80% even at grade 1, and joint space under 2 mm (cited from supporting literature) carries 86-89% conversion to total hip replacement. Second: at the time of arthroscopy, full-thickness femoral cartilage loss (Outerbridge grade 4) should prompt a frank conversation about arthroplasty. It carries an 11-fold increased odds of eventual conversion.
For the appropriately selected patient (no OA, no dysplasia, correctable bony morphology), you can quote them 91.6% survivorship and 90% satisfaction at a decade.
One nuance worth knowing: the UCLA activity score returned to baseline at 10 years despite sustained improvements in pain and function. This is an age effect, not a hip effect. Avoid using activity-composite scores like iHOT for long-term FAI follow-up, where natural aging will artificially depress the score.