Background: Although femoral osteoplasty is common practice in treating cam-type femoroacetabular impingement (FAI), long-term data are lacking that support the ability of this procedure to optimize outcomes and alter natural history. Purpose: To compare long-term clinical outcomes and survivorship of treatment for symptomatic FAI via arthroscopic correction of labral or chondral pathology with and without femoral osteoplasty. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective cohort study was performed across 2 consecutive cohorts of patients with isolated cam-type FAI who underwent hip arthroscopic treatment of labral or chondral pathology without femoral osteoplasty (HS group) or with femoral osteoplasty (HS-OST group). These unique cohorts were established at a distinct transition time in our practice before and after adoption of femoral osteoplasty for treatment of FAI. Clinical outcomes were measured using the modified Harris Hip Score (mHHS). Kaplan-Meier analysis was used to assess for total hip arthroplasty (THA)–free and reoperation-free survivorship. Results: The final HS group included 17 hips followed for 19.7 ± 1.2 years, and the final HS-OST group included 23 hips followed for 16.0 ± 0.6 years. No significant patient or morphological differences were found between groups. Compared with the HS group, the HS-OST group had significantly higher final mHHS (82.7 vs 64.7 for HS-OST vs HS, respectively; P = .002) and mHHS improvement (18.4 vs 6.1; P = .02). The HS-OST group also had significantly greater 15-year THA-free survivorship versus the HS group (78% vs 41%, respectively; P = .02) and reoperation-free survivorship (78% vs 29%; P = .003). Conclusion: This study demonstrated superior long-term clinical outcomes and survivorship with combined arthroscopy and femoral osteoplasty compared with hip arthroscopy alone. These long-term data strongly support the practice of femoral osteoplasty in patients with cam FAI morphologies and suggest that this treatment alters the natural history of FAI at long-term follow-up.

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Background Many students participate in sports during high school, with many of them taking part in multiple sports depending on the season. Injuries sustained during these activities may impact future participation and overall health of the student. Objectives To determine the prevalence, rate and possible risk factors for high school sports injuries Methods A sports injury survey was administered to high school students' self-reporting sports activity during the past year. Sport played, level of play (varsity, junior varsity or club level), occurrence of injury and duration of injury were recorded. 15 sports were queried in the survey; sports were classified into contact sports vs non-contact sports. Statistical analysis of the categorical data was completed using Chi-square test of independence and logistic regression. Results 214 high school students reporting some level of sports activity over the previous year completed the injury survey; 109 (51%) were male and average 16.2 (±1.1) years of age. 105 (49%) participants reported suffering an injury during the previous year, with 64 (59%) of the injuries lasting less than three weeks in duration. Of these 105 injuries, 68 (65%) occurred while playing a contact sport (defined as soccer, football, basketball, wrestling, lacrosse, ice and field hockey). For those playing a contact sport, unadjusted odds of receiving an injury were 3300% increased over those playing a non-contact sport (OR=34.0, 95% CI:(8.3, 138.7), P<0.001); logistic regression model adjusting for age and gender also estimated a significant effect. In a logistic regression model, an association between injury lasting three weeks or longer and level of sport played, contact sport, gender and age failed to be statistically established. Conclusions ∼50% of high school students participating in sports, and 65% of those paying contact had an injury. Most injuries lasted less than 3 weeks. Long-term impact of these injuries needs further study. These high rates of injury to high school age children may require possible more oversight and regulation of these activities. Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.5543

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