Minimum 5-Year Outcomes After Arthroscopic Subspine Decompression in Patients With Femoroacetabular Impingement: A Propensity-Matched Study

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).

AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing

Why it mattersHip 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.

Presenting this at rounds? Start here

• ?This is a single-surgeon retrospective cohort with propensity matching rather than randomization; 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?
• ?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?