A Comparison of Clinical Outcome Between Athletes and Nonathletes Undergoing Hip Arthroscopy for Femoroacetabular Impingement

Murata, Yozo; Uchida, Soshi; Utsunomiya, Hidetsuna; Hatakeyama, Akihisa; Nakamura, Eiichiro; Sakai, Akinori

doi:10.1097/jsm.0000000000000367

Cited by 40 publications

(45 citation statements)

References 40 publications

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“…There is a paucity of literature on female athletes’ postoperative outcomes compared with their nonathletic female counterparts. Murata and colleagues 36 compared a cohort of athletes (47 patients) with a cohort of nonathletes (27 patients), which included both women and men in both groups, and reported that the mean Non-Arthritic Hip Score was superior in the athlete group at all postoperative time points and that the mHHS was superior in the athlete group only at 2 years postoperatively. These results are in agreement with those of the current study suggesting that female athletes have superior postoperative outcome scores at a minimum of 2 years postoperatively when compared with their nonathlete counterparts.…”

Section: Discussionmentioning

confidence: 99%

“…§ Notably, it has been suggested that athletes experience improved postoperative outcomes compared with nonathletes. 36 However, as the previous literature has mainly focused on the male population, the primary aim of the present study was to (1) compare the PROs and satisfaction of athletic versus nonathletic female patients undergoing hip arthroscopic surgery for FAIS and (2) determine the return-to-sports rate and time to return to sports in female athletes. We hypothesized that female athletes would experience better outcomes than their nonathlete counterparts and that female athletes would have a high rate of return to sports.…”

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confidence: 99%

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Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis

Frank

Kunze

Beck

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Female patients undergoing surgery for femoroacetabular impingement syndrome (FAIS) often experience inferior clinical outcomes and higher failure rates when compared with male patients. The influence of athletic status on hip arthroscopic outcomes in female patients, however, is unclear.Purpose:To compare patient-reported outcomes (PROs) of athletic and nonathletic female patients undergoing hip arthroscopic surgery for FAIS, and to determine the return-to-sports rate in the athlete group.Study Design:Cohort study; Level of evidence, 3.Methods:Two-year PROs were assessed in female patients who had undergone hip arthroscopic surgery for FAIS by a single surgeon. Patients who self-identified as athletes were compared with nonathletes. Preoperative and postoperative PRO scores including the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport-Specific (HOS-SS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction were analyzed and compared between athletes and nonathletes. Subanalysis was performed based on patient age and body mass index (BMI).Results:A total of 330 female patients undergoing hip arthroscopic surgery for FAIS were identified. Of these, 221 patients identified as athletes (mean age, 29.1 ± 11.1 years; mean BMI, 23.0 ± 3.5 kg/m2) and 109 as nonathletes (mean age, 39.3 ± 11.4 years; mean BMI, 27.8 ± 5.8 kg/m2). Both groups demonstrated improvements in HOS-ADL, HOS-SS, mHHS, VAS for pain, and VAS for satisfaction scores (P < .001 for all). Athletes had significantly higher postoperative PRO scores compared with nonathletes (P < .001 for all). A 1:1 matched-pair subanalysis of 97 athletes and 97 nonathletes controlling for age and BMI indicated that these relationships held independently of potential demographic confounders (P < .001 for all). The number of patients meeting the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for the HOS-ADL, HOS-SS, and mHHS was significantly higher in athletes aged ≤25 years versus those aged >25 years and for athletes versus nonathletes (P < .05 for all). Further, 189 of 194 athletes returned to sports at a mean of 6.0 ± 3.9 months postoperatively, with 93.7% reporting returning to the same or higher level of competition.Conclusion:Among female patients undergoing hip arthroscopic surgery for FAIS, patients considered athletes achieved superior clinical outcomes compared with patients considered nonathletes. In addition, younger female athletes had higher rates of achieving the MCID and PASS for all PRO measures.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis

Frank

Kunze

Beck

et al. 2019

Orthopaedic Journal of Sports Medicine

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“…Then, osteochondroplasty is performed as described previously. 11 In patients with associated hip dysplasia or instability, a shoelace capsular plication should be also performed to provide soft tissue stability. This last one should be performed as previously described using UltraTape (Smith & Nephew) ( Fig 3 E).…”

Section: Surgical Techniquementioning

confidence: 99%

Arthroscopic Management for Acetabular Rim Stress Fracture and Osteochondritis Dissecans in the Athlete With Hip Dysplasia

Uchida

Shimizu

Yukizawa

et al. 2018

Arthroscopy Techniques

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Intra-articular lesions are common in patients with acetabular hip dysplasia. Rim stress fractures (RSFs) have also been described in patients with acetabular hip dysplasia. This lesion is believed to be a result of an unfused secondary ossification center or a stress fracture that could be caused by repetitive impingement of an abnormal-shaped femoral head-neck junction. In addition, osteochondritis dissecans of the acetabulum is a rare condition that can also result from impingement and has been described in patients with hip dysplasia. Here, we describe an arthroscopic technique for internal fixation of osteochondritis dissecans of the acetabulum and concomitant RSF associated with hip dysplasia in a rhythmic gymnast.

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“…In phase 3, endurance strengthening was commenced only after ROM was maximized and after good stability in gait and movement was demonstrated. Patients were allowed to progress their physical activity only after passive ROM was symmetric and pain free, and they demonstrated a normal gait pattern [22].…”

Section: Rehabilitation Protocolmentioning

confidence: 99%

Arthroscopic anterior inferior iliac spine decompression does not alter postoperative muscle strength

Tateishi

Onishi

Suzuki

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Purpose The purpose of this study was to assess the additional effect of anterior inferior iliac spine (AIIS) decompression on knee extensor and hip flexor strength and compare functional outcomes after arthroscopic FAI correction with and without AIIS decompression. Methods Sixty patients who underwent arthroscopic FAI correction surgery were divided into two groups matched for AIIS morphology: 31 patients who underwent arthroscopic FAI surgery only (without AIIS decompression) (FAI group) (AIIS Type I; n = 5, Type II; n = 26, Type III; n = 0) and 29 patients who underwent arthroscopic FAI surgery with AIIS decompression (AIIS group) (AIIS Type I; n = 5, Type II; n = 24, Type III; n = 0). Knee extensor and hip flexor strength were evaluated preoperatively and at 6 months after surgery. Patient-reported outcome (PRO) scores using the modified Harris hip score (MHHS), the nonarthritic hip score (NAHS) and iHOT-12 were obtained preoperatively and at 6 months after surgery. Results In the AIIS group, there was no significant difference between knee extensor strength pre-and postoperatively (n.s.). In the AIIS group, hip flexor strength was significantly improved postoperatively compared to preoperative measures (p < 0.05). In the FAI group, there were no significant improvements regarding muscle strength (n.s.). While there were no significant differences of preoperative and postoperative MHHS and NAHS between both groups (MHHS; n.s., NAHS; n.s.), the mean postoperative iHOT-12 in the FAI group was inferior to that in the AIIS group. (p < 0.01). The revision surgery rate for the AIIS group was significantly lower compared with that in the FAI group (p < 0.05). Conclusion Anterior inferior iliac spine decompression, as a part of an arthroscopic FAI corrective procedure, had a lower revision surgery rate and did not compromise knee extensor and hip flexor strength, and it improved clinical outcomes comparable to FAI correction without AIIS decompression. AIIS decompression for FAI correction improved postoperative PRO scores without altering the muscle strength of hip flexor and knee extensor. Level of evidence III.

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A Comparison of Clinical Outcome Between Athletes and Nonathletes Undergoing Hip Arthroscopy for Femoroacetabular Impingement

Abstract: Although arthroscopic FAI correction and labral preservation surgery is generally beneficial, it appears to provide a better clinical outcome in athletes than in nonathletes.

Cited by 40 publications

References 40 publications

Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis

Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis

Arthroscopic Management for Acetabular Rim Stress Fracture and Osteochondritis Dissecans in the Athlete With Hip Dysplasia

Arthroscopic anterior inferior iliac spine decompression does not alter postoperative muscle strength

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