Editorial Commentary: Clinical Equipoise Regarding Arthroscopic Management of Femoroacetabular Impingement With Tönnis Grade 2 Osteoarthritis May Mean We Don't Know or Don't Agree: It Does Not Mean We Don't Care.

ABSTRACT

Management of patients with femoroacetabular impingement and moderate (Tönnis grade 2) osteoarthritis remains a debated topic. Outcomes show that such patients can benefit from hip arthroscopy, yet the improvement may not be as favorable as desired. Although certain factors, such as Tönnis grade 3 hip OA, older age, higher body mass index, bipolar cartilage defects, and joint space less than 2 mm, may influence surgeons to avoid arthroscopic treatment, the threshold for grade 2 OA is not as clear. Moreover, although radiographs may appear similar in patients with Tönnis grade 2, there may be a wide range of chondral damage seen arthroscopically. Thus, until higher-level studies are performed, it is the responsibility of the surgeon to delineate appropriate treatment strategies for individual patients in this category, and most of all, it is crucial for surgeons to set reasonable expectations for patients when considering hip arthroscopy. This highlights the importance of careful preoperative evaluation and patient education.