EP6.117 Preoperative Hip Injection Response Does Not Reliably Predict 2-Year Postoperative Outcomes Following Hip Arthroscopy for Femoroacetabular Impingement

• DOI: 10.1093/jhps/hnaf011.404
• Publication Date: 2025-03-30T17:39:23Z
• Authors: Alan Zhang; Lelja Pepic; Alexander Markes; Kylen Soriano; Stephanie Wong

Abstract Purpose: The purpose of this study is to determine whether response to preoperative local anesthetic or corticosteroid intra-articular injections can predict 2-year postoperative outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Methods: This was a retrospective analysis of patients undergoing hip arthroscopy for FAIS at a single institution from 2014-2020. Patients who underwent preoperative intra-articular hip injection were classified based on injection type (local anesthetic, corticosteroid) and whether they experienced pain relief following injection (responders, non-responders). Responders were matched 2:1 by age, BMI, and sex with non-responders. Patient reported outcomes (PROs) including Hip Disability and Osteoarthritis Outcome Score (HOOS), 12-item Short-Form Survey mental (SF-12-MCS) and physical component summary (SF-12-PCS) and visual analogue scale (VAS) pain were collected preoperatively and 2-years postoperatively. Mean score change and Minimal Clinically Important Difference (MCID) achievement were calculated and compared between groups. Results: The matched cohort included 126 total patients (42 non-responders, 84 responders; 74.6% female; mean ± SD age: 30.9 ± 9.9 years; BMI: 24.7 ± 3.7 kg/m2) with no differences in demographic or radiographic hip variables. Both groups demonstrated significant 2-year postoperative score improvements across all PROs, except SF-12-MCS, which remained unchanged. There was no difference in mean score change or MCID achievement across all PROs between corticosteroid injection responder and non-responder groups. Significant ceiling effects were most readily apparent among the injection responders group with greater percentages of patients achieving maximal 2-year postoperative survey scores (36.9% in HOOS-ADL, 19.0% in HOOS-Pain, 15.5% in HOOS-QoL, and 32.1% in HOOS-Sport). Conclusions: Preoperative injection response with either corticosteroid or local anesthetic did not predict 2-year outcomes after hip arthroscopy in patients with FAIS. Given these findings, we caution against the use of injection response as an isolated variable in the prediction of postoperative outcomes and determination of surgical candidacy in FAIS treatment.