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Sarantos Nikou: Lasting improvement after hip-preserving surgery

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The Institute of Clinical Sciences

Most patients who undergo arthroscopic surgery for the hip condition femoroacetabular impingement syndrome experience reduced pain and improved function even a decade later. Sarantos Nikou’s research helps refine patient selection and long-term follow-up.

Sarantos Nikou, orthopaedic surgeon at Sahlgrenska University Hospital and doctoral student at the Institute of Clinical Sciences.

SARANTOS NIKOU
Dissertation defense: 9 December 2025 (click for details)
Doctoral thesis: Hip arthroscopy and the continuum of joint degeneration: outcomes, indications, and long-term perspectives
Research area: Orthopaedics
Sahlgrenska Academy, The Institute of Clinical Sciences

Femoroacetabular impingement syndrome (FAIS) occurs when a bony prominence on the femoral head creates abnormal contact between the bones of the hip joint. This leads to pain and reduced mobility.

The condition mainly affects young and middle-aged individuals with high activity levels, and arthroscopic surgery has become a common joint-preserving treatment. Sarantos Nikou has studied how patients fare in the long term after the procedure.

Cover illustration: Showing the alpha angle used to quantify cam morphology in femoroacetabular impingement syndrome (FAIS). A higher alpha angle indicates reduced head–neck offset and abnormal contact with acetabular rim. Illustration by Pontus Andersson.

Sustained improvement over ten years

The research shows that most patients report sustained improvement in pain relief and mobility up to ten years after arthroscopic treatment for FAIS. Outcomes were best among younger patients and those with limited cartilage damage.

“ The findings help refine patient selection, set realistic expectations, and support hip preservation in carefully selected patients,” says Sarantos Nikou, orthopaedic surgeon at Sahlgrenska UniversityHospital and doctoral student at the Institute of Clinical Sciences.

Figure from the thesis: Arthroscopic view of the hip showing a cam deformity at the femoral head–neck junction after resection. The burr is used to restore normal concavity and improve joint clearance during motion.

Better tools for patient selection

The findings support a more refined approach to who should be offered hip-preserving surgery. By identifying which patients are most likely to benefit, surgeons can improve long-term results and avoid unnecessary procedures.

“Hip preservation is not suitable for everyone, but when performed for the right reasons and in the right patients, it can significantly improve quality of life.”

Figure from the thesis: The flexion-adduction–internal rotation (FADIR) test used in diagnosing FAIS. The maneuver reproduces hip impingement symptoms by bringing the femoral neck into contact with the acetabular rim. Illustration by Pontus Andersson.

Rewarding to develop research methods

What have been the most rewarding and challenging parts of your doctoral project?
“The most rewarding part has been following patients over a full decade and seeing how the treatment truly impacts their lives long term. Collaborating with experienced colleagues and developing research methods has also been inspiring,” says Sarantos Nikou, and continues:

“The main challenge has been managing large datasets and ensuring high-quality follow-up over many years.”

Text: Jakob Lundberg

Area
Health and medicine
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