So first and foremost I want to thank my co-authors for their contribution to this project as well as AOSSM for inviting me to present today. For this project the authors have no relevant disclosures but the authors' disclosures can be seen on the website or the app. So as we know, FAA is a common cause of hip pain among the adolescent population and treatment options include either surgical hip dislocation or hip arthroscopy with hip arthroscopy becoming increasingly more prevalent over the last decade. Most of these patients have good outcomes, however, up to 1 in 10 will still undergo revision operation. In the adult population, predictors of poor outcomes include inadequate CAM resection and a higher tonus angle. However, there's a paucity of literature that evaluate radiographic risk factors in the adolescent population. Therefore the purpose of my study was to determine whether preoperative radiographic parameters predicted reoperation in adolescents undergoing surgery for FAI. The study consisted of prospective data from the Scottish Rite Global Hip Registry looking at outcomes of hip preservation with a minimum of two-year follow-up. Typical treatment included osteochondroplasty, acetabuloplasty, labor repair, or a combination of these procedures. Preoperative radiographic measurements were taken and I then compared two cohorts defined as success, which had no reoperation, and the second cohort, failure, required a second procedure for continued hip pain. I want to highlight pertinent acetabular measurements I used in this study including lateral center edge angle, tonus angle, sharps, and fear index. There were a total of 91 hips in our study with an average age of approximately 16. Three-quarters were females. Two-thirds underwent surgical hip dislocation. And my results demonstrate failures had radiographic evidence of less acetabular coverage over the femoral head that was statistically significant for all four acetabular measurements. For example, the mean lateral center edge angle of failures was 22.69 degrees compared to the success cohort with a lateral center edge angle of 26.68. We therefore performed a receiver operating characteristic plot to test the ability to predict a certain result. These values are the optimal cutoff to determine negative or positive results, or in our study, reoperation versus no reoperation. Based on this analysis, a lateral center edging of less than 22 degrees, fear index greater than negative 8.7, tonus of greater than 6, and a sharps angle greater than 44 degrees in isolation may be at risk for repeat operation. To further highlight these cutoffs, this graph illustrates our reoperation rates based on these values. So as you can see, patients with lateral center edge angle less than 22 had a 43% rate of repeat reoperation. And those with a lateral center edge angle greater than 22 degrees only had an 8% rate of reoperation. These reoperation rates were consistent throughout our derived cutoff values for fear index, tonus angle, as well as sharps angle. So this study demonstrates that preoperative radiographic measurements may be associated with reoperation when treating patients for FAI in an adolescent population. It also demonstrates that combined methodology may contribute to these reoperations. There may be a role for capsular placation or PAO. In conclusion, radiographic acetal values can be useful in predicting failures of hip preservation surgical treatment for FAI. And caution should exist for adolescent patients undergoing surgical treatment for FAI if the lateral center edge angle is less than 22 degrees or a tonus angle greater than 6. Thank you.

Femoroacetabular Impingement

hip arthroscopy

surgical hip dislocation

radiographic measurements

reoperation