Rate of Mechanical Symptom Resolution at 2-Year Follow-up After Hip Arthroscopy.

Background: Mechanical symptoms, such as catching, locking, and giving out, are common concerns for patients with acetabular labral tears prior to hip arthroscopy. Yet the rate at which they resolve following hip arthroscopy remains poorly understood. Purpose: To use the Nonarthritic Hip Score (NAHS) to evaluate the rate at which mechanical symptoms resolve after primary hip arthroscopy for patients with symptomatic labral tears. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective review of prospective data for patients who underwent primary hip arthroscopy from May 2014 to March 2023. Mechanical symptoms were assessed using 3 NAHS items: catching or locking, giving out, and stiffness, each rated on a Likert scale (0-4). Patients who reported preoperative scores of ≤3 were classified as symptomatic, while patients with a 4 were classified as asymptomatic. Symptom resolution was defined as improvement to a score of 4 after surgery at 24 months postoperatively. Univariate analyses identified factors associated with symptom resolution, and a multivariate logistic regression was used to determine independent predictors. Functional outcomes were compared between groups with resolved and persistent symptoms using NAHS subscales. Results: Among 228 patients (age range, 18-64 years), stiffness was the most common preoperative symptom (85.5%), followed by catching/locking (65.8%), and giving out (36.4%). At 24 months, resolution rates were 80.7% for giving out, 59.3% for catching/locking, and 29.7% for stiffness. For patients who were asymptomatic at baseline, very few patients developed symptoms of catching/locking or giving way (14.1% and 4.1%, respectively); however, 45.5% of patients who reported no stiffness at baseline reported some at 24 months. Multivariable analysis identified lower Tönnis angle and higher center-edge angle as independent predictors for resolution of giving out. Patients with resolved mechanical symptoms demonstrated significantly higher NAHS subscores for the majority of items at 2 years compared to those with persistent symptoms ( Conclusion: Hip arthroscopy efficiently resolves mechanical symptoms such as catching/locking or giving out while significantly improving functional outcomes. However, persistent stiffness was a common postoperative issue. Patients should be informed preoperatively that residual stiffness may improve with surgery but not be completely alleviated.