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

This retrospective, propensity-matched cohort study from a single high-volume hip preservation center followed 94 patients who underwent arthroscopic subspine decompression (SSD) for AIIS impingement alongside FAI correction and compared them to 188 matched controls who had FAI surgery alone. At a mean follow-up of about 6 years, the SSD group showed large, statistically significant improvements in all patient-reported outcome scores (P<.0001), with rates of achieving meaningful clinical improvement (MCID/PASS) and conversion to hip arthroplasty (5.3% vs 17.4%, not statistically significant) similar to controls, while time to revision arthroscopy was significantly longer in the SSD group (52.0 vs 32.8 months).

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

Why it mattersFor residents learning hip arthroscopy, this suggests that treating subspine impingement concurrently with FAI correction does not compromise, and may even extend, the durability of surgical results at mid-term follow-up.

Presenting this at rounds? Start here

• ?This was a retrospective, single-surgeon cohort study with no blinded outcome assessment and no mention of correction for the many statistical comparisons performed across five PRO instruments and subgroup analyses; how might these factors have inflated the apparent robustness of the findings?
• ?Given that the SSD group had more severe intra-articular pathology (more femoroplasty and loose-body removal) yet achieved outcomes comparable to a less-diseased control group, how should this inform patient selection and threshold for performing SSD intraoperatively?