Sex-Based Differences in the Arthroscopic Treatment of Femoroacetabular Impingement Syndrome: 10-Year Outcomes With a Nested Propensity-Matched Comparison
Authors
Domb BG, Kufta AY, Kingham YE, Sabetian PW, Harris WT, Perez-Padilla PA
Background
Sex-based differences in hip structure and pathology may affect outcomes after arthroscopic surgery for femoroacetabular impingement syndrome (FAIS), but long-term comparative data are limited.
Methods
This study reviewed 375 hips (249 females, 126 males) that underwent primary arthroscopic surgery for FAIS with a 10-year follow-up. A subanalysis matched female and male patients 1:1 by age and BMI to compare patient-reported outcomes (PROs), satisfaction, and surgical details.
Key Findings
- Both groups showed significant improvement in PROs over 10 years.
- Female patients had higher satisfaction and greater improvements in mHHS, NAHS, HOS-SSS, and pain (VAS).
- Male patients had more severe cartilage damage and underwent femoroplasty more often.
- Females were more likely to have capsular repair and iliopsoas lengthening.
- Both sexes had high survivorship (avoiding total hip replacement).
Conclusion
Men and women benefit equally from hip arthroscopy over 10 years, though women report greater satisfaction and improvement, despite undergoing more secondary procedures.
What Does This Mean For Patients
Both men and women experience long-term benefits from hip arthroscopy for FAIS, with women showing greater improvement and satisfaction, even if they need additional procedures in the future.