Dr. Matt Schmitz, JBJS Senior Editor for Pediatrics and Social Media, shares this post on a new study in JBJS.
Femoroacetabular impingement (FAI) is increasingly recognized as a source of hip pain and joint deterioration as well as a potential cause of premature osteoarthritis. While the recognition of FAI and related surgical treatment has exploded over the past couple of decades, there have been few studies examining mid- to long-term outcomes.
The June 3, 2026 issue of The Journal presents the results of a prospective, multicenter investigation by Nepple et al. of the ANCHOR (Academic Network of Conservational Hip Outcomes Research) Study Group that evaluated mean 10-year outcomes of surgical intervention for FAI, looking not only at patient-reported outcomes but survivorship (hips not progressing to the need for total hip arthroplasty [THA]). The study is part of a new special issue on sports medicine now available at JBJS.org.
The study included 452 hips treated between 2008 and 2012, with 362 hips (80.1%) having a minimum of 8 years of follow-up and assessed for THA-free survivorship. Of the 362 hips, 77% had undergone hip arthroscopy and 23% had open surgical hip dislocation. The mean patient age was 32 years at the time of surgery, and 53% of the hips were in female patients.
THA-Free Survivorship
The overall THA-free survivorship was 90.6% at 10 years, with Kaplan-Meier estimates of 95.0% at 5 years and 90.5% at 10 years. Among hips that had not undergone conversion to THA, functional outcomes were meaningful, with the modified Harris hip score improving from a mean of 62.1 preoperatively to 85.5 at follow-up, and 86.9% of hips reaching the minimal clinically important difference and/or patient acceptable symptom state. Cox proportional-hazards regression identified 4 independent predictors of conversion to THA: older age at surgery, male sex, body mass index of ≥30 kg/m², and femoral head chondromalacia.
Hips with any degree of femoral head chondromalacia had a 10-year THA-free survival probability of only 71.5%, compared with 95.1% in those without. Hips in patients under 30 years of age had a 97.4% 10-year survival probability versus 84% for those in patients 30 and older.
The authors concluded that FAI surgery offers durable mid-term hip preservation, and their findings may help inform patient selection, preoperative counseling, and surgical decision-making.
In full disclosure, I am a member of the ANCHOR Study Group, but the cohort in this study was enrolled before I became a member, and I was not involved in this manuscript. Still, 80% follow-up over 10 years is incredible, and kudos to the authors for their diligence in this project. More and more research is showing that surgical treatment of FAI can provide durable results, and identifying which patients will do best (younger, less femoral head disease) is paramount to obtaining good and sustained outcomes.
The full study and a related visual abstract are available at JBJS.org: Survivorship of Femoroacetabular Impingement Surgery at Mean 10-Year Follow-up. A Prospective, Multicenter Cohort Study
Additional perspective on this study is provided in a commentary by Michael Wettstein, MD and Panayiotis Christofilopoulos, MD: Navigating the Next Decade of Hip Preservation
Matthew R. Schmitz, MD
JBJS Senior Editor for Pediatrics and Social Media
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