Durable Mid-Term Outcomes and High Rates of Meaningful Improvement After Hip Arthroscopy With Concomitant Periacetabular Osteotomy.

Purpose: To evaluate 5-year outcomes following combined hip arthroscopy and periacetabular osteotomy (PAO) for the treatment of acetabular dysplasia and intra-articular pathology, with a focus on the rates of achieving clinically meaningful outcome thresholds. Methods: Minimum 5-year outcome data from a prospectively maintained database were queried to identify patients who underwent concomitant primary hip arthroscopy and PAO between October 2010 and July 2019. Patient-reported outcomes evaluated included the modified Harris Hip Score (mHHS), non-arthritic hip score (NAHS), hip outcome score sport-specific subscale (HOS-SSS), and international hip outcome tool 12 (iHOT12). Clinically meaningful thresholds were also assessed, including minimal clinically important difference (MCID), patient-acceptable symptom state (PASS), and substantial clinical benefit (SCB). Results: A total of 32 hips were included in this study. All PROs demonstrated significant improvement from the preoperative baseline to the 5-year follow-up (P < .001). Clinical outcomes remained durable, with no significant decline observed between 2-year and 5-year follow-ups (mHHS P = 0.612; NAHS P = 0.701; iHOT-12 P = 0.284; HOS-SSS P = 0.158). Similarly, achievement rates for MCID, PASS, and SCB thresholds were sustained over time (P = 0.105 to >0.999). Two hips (5.7%) converted to total hip arthroplasty (THA). Conclusions: Concomitant hip arthroscopy and PAO are an effective procedure with durable 5-year outcomes. Patients demonstrated sustained improvements and a high rate of clinically meaningful success, supporting the value of this combined approach in appropriately selected cases. Level of Evidence: Level IV: Retrospective therapeutic case series.