Early improvement in quality of life predicts two-year patient acceptable symptom state after arthroscopic hip surgery for femoroacetabular impingement syndrome

Arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) generally improves symptoms; however, a proportion of patients fail to achieve acceptable outcomes. Early postoperative improvement may serve as a prognostic indicator, yet evidence remains inconsistent. This study tested the hypothesis that initial 12-week changes in the 33-item International Hip Outcome Tool (iHOT-33) scores would predict achievement of a Patient Acceptable Symptom State (PASS) at 2-years following hip arthroscopy for FAIS. This retrospective cohort study included 258 patients (mean age: 39 ± 13 years, 55% female) who underwent arthroscopic surgery for FAIS between 2012 and 2016. Patients completed the iHOT-33 preoperatively and at 12-weeks and 2-years postoperatively. Logistic regression assessed the association between 12-week iHOT-33 change scores and 2-year PASS, adjusting for age, sex, body mass index, Kellgren-Lawrence grade, and FAIS type. Predictive performance was evaluated using receiver operating characteristic (ROC) analyses, with optimal thresholds determined using Youden’s index. Greater 12-week improvement in iHOT-33 scores was independently associated with higher odds of achieving PASS [odds ratio (OR) = 1.02, 95% confidence interval (CI) (1.01–1.04), P = .043]. ROC analysis demonstrated fair discrimination [area under the curve = 0.61, 95% CI (0.54–0.68)]. The optimal cutoff for predicting 2-year PASS was a 10.4-point improvement at 12-weeks (sensitivity = 0.53, specificity = 0.69). Early postoperative improvement in iHOT-33 scores may provide prognostic information for 2-year outcomes following arthroscopic surgery for FAIS. Early changes may help identify patients at risk for suboptimal recovery who could benefit from targeted intervention. Level of Evidence: Level III (Observational Studies).