Minimum 5-Year Outcomes After Arthroscopic Subspine Decompression in Patients With Femoroacetabular Impingement: A Propensity-Matched Study
The American Journal of Sports Medicine · 23 Jul 2026
† Impact is the editorial-priority score. All scores are out of 100. Clinical is a stored clinical-importance score from the earlier method; it has not been recalculated.
Why it matters
Hip arthroscopists often encounter subspine impingement alongside FAI, and this study offers reassurance that concurrent decompression does not compromise, and may even improve, midterm durability compared to FAI surgery alone.
The evidence
This retrospective, propensity-matched cohort study followed 94 patients who underwent arthroscopic subspine decompression (SSD) alongside FAI correction and compared them to 188 matched controls without subspine impingement, all with at least 5 years of follow-up. Both groups improved significantly from baseline on all patient-reported outcome scores (p<.0001), and rates of achieving clinically meaningful improvement (MCID/PASS) were similar between groups; the SSD group had a numerically lower but statistically similar conversion-to-arthroplasty rate (5.3% vs 17.4%, though p=.61 reported for that comparison) and a significantly longer time to revision arthroscopy (52.0 vs 32.8 months, p=.04).
Conversion to total hip arthroplasty or resurfacing: Risk difference -12.1 (95% CI unavailable; units not reported).
Why this rigour score?
Retrospective cohort
Methods at a glance
Recorded assessment- Confounding adjustmentPropensity scores
- Covariate balance confirmedNot reported
- Outcome assessors blindedNot reported
- Comparable start of follow-upMet
- Adequate statistical powerMet
- Prospective registrationNot reported
Not reported does not mean not done. Checks have different weights; this is not a count of boxes ticked.
How to read this assessment
The recorded methods are shown alongside the published score. A verified point-by-point calculation is not available for this version of the appraisal.
Checklist from the stored appraisal. “Not met” describes the recorded criterion; it does not always produce a deduction. This overview supports reading the full study.
For journal club
1.This is a single-surgeon retrospective cohort with propensity matching rather than randomisation; how might unmeasured confounders like femoral version or activity level have influenced the comparable outcomes and the paradoxical p=.61 result reported for a rate that looks numerically quite different?
2.Given that outcomes were 'comparable' rather than superior, how should a surgeon weigh the added operative time and risk of AIIS decompression against its uncertain independent benefit when SSI is identified intraoperatively?
Original publication title
Minimum 5-Year Outcomes After Arthroscopic Subspine Decompression in Patients With Femoroacetabular Impingement: A Propensity-Matched Study