Psychiatric Comorbidity Is Associated With Increased Failure Rates and Inferior Clinical Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome at a Minimum 10-Year Follow-up

This retrospective cohort study followed 243 adults who had hip arthroscopy for femoroacetabular impingement syndrome (FAIS) for a minimum of 10 years, comparing those with a documented psychiatric diagnosis (30%) to those without. Patients with psychiatric comorbidity had a much higher failure rate (revision arthroscopy or conversion to THA) at 23.3% versus 5.3%, and this comorbidity independently predicted failure on adjusted Cox regression (HR 2.84, 95% CI 1.17-6.88). Both groups improved significantly on hip function scores after surgery, but patients with psychiatric comorbidity started lower, ended lower, and improved less than those without.

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

Why it mattersThis suggests surgeons should screen for and counsel patients about psychiatric comorbidity before hip arthroscopy, since it appears to meaningfully worsen long-term implant/procedure survival and patient-reported outcomes.

Presenting this at rounds? Start here

• ?Should a positive psychiatric history change how surgeons counsel FAIS patients about expected improvement and failure risk before hip arthroscopy?
• ?Would preoperative mental health optimization (therapy, medication review) before hip arthroscopy plausibly reduce the observed failure gap, or does this study only show association rather than a modifiable pathway?