Do Professional Athletes Perform Better Than Recreational Athletes After Arthroscopy for Femoroacetabular Impingement?

Abstract

Background Although a large number of athletes' returns to sports after hip arthroscopic surgery for femoroacetabular impingement (FAI), it is not clear if they do so to the preinjury level and whether professional athletes (PA) are more likely to return to the preinjury level compared with recreational athletes (RA). Questions/purposes We therefore compared (1) the time taken to return to the preinjury level of sport between professional and recreational athletes; (2) the degree of improvement in time spent in training and competitive activities after arthroscopic surgery for FAI; and (3) the difference in trend of improvement in hip scores. Methods We prospectively followed 80 athletes (PA = 40, RA = 40; mean age, 35.7 years; males = 50, females = 30; mean followup, 1.4 years; range, 1-1.8 years) who underwent hip arthroscopy for FAI. We measured the time to return to sports; training time and time in competition; and the modified Harris hip score and the nonarthritic hip score.

Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: a systematic review with meta-analysis

“…Four studies14 28 31 32 (11% of all studies) were level 3b evidence, and 31 studies21–27 29 33–54 (89%) were level 4 evidence 11. The methodological quality of scores ranged from 624 to 16,26 with a median of 9 (online supplementary appendix III). Twenty-seven studies (77%) were of moderate quality14 21–23 25–32 35 38 40–48 50 51 53 54 and eight (23%) were of low quality 24 33 34 36 37 39 49 52.…”

“…Five (14%) studies26 32 35 39 43 reported on preinjury and postsurgery athletic performance in football (soccer),35 running,39 ice hockey,32 golf43 and multiple sports 26. Performance measurements included the average number of starts in professional football players,35 decreased running mileage in non-professional athletes (p=0.013),39 decreased performance data (p=0.024) in professional hockey players32 and reaching the greens in regulation for professional golfers (no difference between presurgery and postsurgery; p=0.227) 43.…”

“…Performance measurements included the average number of starts in professional football players,35 decreased running mileage in non-professional athletes (p=0.013),39 decreased performance data (p=0.024) in professional hockey players32 and reaching the greens in regulation for professional golfers (no difference between presurgery and postsurgery; p=0.227) 43. A study of 80 athletes in various sports with a mean follow-up of 17 months found an improvement in the time/week in sport competition from a mean of 2.5 hours before surgery to 5.2 hours 6 months after surgery (p=0.02) and 7.9 hours 1 year after surgery (p<0.001) 26. Actual performance in sport competition was not reported.…”

Rehabilitation after Hip Arthroscopy

“…[32] Most of the opinion leaders [15,21,31,32] agree that return to full competitive activity should usually be recommended between twelfth and sixteenth post-operative weeks and a recent review [33] showed that 70% of surgeons recommended 12 to 20 weeks as timeframe to sport return while 85% of surgeons recommended that patients need to be able to reproduce all motions involved in their sport without pain as leading criteria. Unfortunately up to date, in literature there is no evidence to support this recommendation.…”

Symposium: Advanced Hip Arthroscopy: Editorial Comment

“…First, Dr. Richard Villar and colleagues [5] Fresh views on hip arthroscopy are embodied in the next group of papers. Recent research demonstrated the multiple roles of the acetabular labrum.…”