Long-Term Evaluation of Arthroscopic Treatment for Femoroacetabular Impingement Syndrome: Minimum 15-Year Follow-Up

Objective To evaluate the long-term clinical and functional outcomes of patients who underwent hip arthroscopy for the treatment of femoroacetabular impingement syndrome (FAIS), with a minimum follow-up of 15 years. Methods This retrospective study analyzed data from 117 patients who underwent arthroscopic management of FAIS between July 2002 and July 2010. Surgical video recordings, radiographic imaging, and clinical documentation were systematically reviewed. Variables assessed included patient demographics, lesion characteristics, chondral injury grading (Outerbridge, Konan, and Santa Casa classifications), and surgical procedures performed (labral debridement or repair, femoral osteochondroplasty, and acetabular osteoplasty). Long-term patient-reported outcomes were obtained using the International Hip Outcome Tool (iHOT-33) after a minimum follow-up of 15 years. Results Ninety patients (56 males and 34 females; median age, 35.5 years) met the inclusion criteria. Seven patients (7.7%) required conversion to total hip arthroplasty at a median of 6.7 years post-procedure. The remaining 83 patients achieved a median iHOT-33 score of 88 points after a minimum follow-up of 15 years (median, 17.5 years). Survivorship free from arthroplasty was 92.3% at 15 years. No major complications were observed. Conclusion Arthroscopic management of femoroacetabular impingement provides durable symptom relief and sustained functional improvement, as demonstrated by favorable patient-reported outcomes after more than 15 years of follow-up. Appropriate patient selection remains essential for long-term success. Keywords Femoroacetabular Impingement; Arthroscopy; Hip Joint; Hip Injuries; Treatment Outcome; Follow-Up Studies; Long-Term Outcome.