High-Level Athletes Who Did Not Return to Sport for Reasons Unrelated to Their Hip Achieve Successful Midterm Outcomes With a Benchmarking Against High-Level Athletes Who Returned to Sport

Jimenez, Andrew E.; Monahan, Peter F.; Owens, Jade S.; Lee, Michael S.; Maldonado, David R.; Saks, Benjamin R.; Ankem, Hari K.; Lall, Ajay C.; Domb, Benjamin G.

doi:10.1016/j.arthro.2021.11.040

Cited by 9 publications

(11 citation statements)

References 48 publications

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“…For this study, the mHHS, NAHS, HOS-SSS, VAS for pain, and patient satisfaction were measured at the preoperative and minimum 5-year postoperative time points. 2,18,37,46…”

Section: Methodsmentioning

confidence: 99%

“…For this study, the mHHS, NAHS, HOS-SSS, VAS for pain, and patient satisfaction were measured at the preoperative and minimum 5-year postoperative time points. 2,18,37,46 PRO improvement was assessed using the minimal clinically important difference (MCID) that was described by Norman et al 51 Previous studies have used this method to accurately estimate anchor-based methods. 60,62,64 Unique MCIDs were calculated for the mHHS, NAHS, HOS-SSS, and VAS for pain.…”

Section: Surgical Outcome Toolsmentioning

confidence: 99%

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Basketball Players Undergoing Primary Hip Arthroscopy Exhibit Higher Grades of Acetabular Cartilage Damage but Achieve Favorable Midterm Outcomes and Return to Sports Rates Comparable With a Propensity-Matched Group of Other Cutting Sports Athletes

et al. 2022

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Background: Favorable short-term outcomes in competitive basketball players have been reported. Midterm outcomes in these athletes and how they compare with athletes in sports with similar demands have not been well established. Purpose: (1) To report minimum 5-year patient-reported outcomes (PROs) and return to sports data in competitive basketball players undergoing primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and (2) to compare outcomes with a propensity-matched control group of other cutting sports athletes. Study Design: Cohort study, Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed for basketball players who competed at the professional, collegiate, high school, or competitive amateur levels and underwent primary hip arthroscopy for FAIS between May 2009 and March 2016. Patients with preoperative and minimum 5-year postoperative outcomes for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain were included. Patients were propensity matched to athletes in other cutting sports (soccer, lacrosse, field hockey, and tennis) according to age, sex, body mass index (BMI), and preoperative competition level for comparison. Results: A total of 28 competitive basketball players were included, with a mean follow-up time of 67.1 ± 5.1 months and a mean BMI of 23.7 ± 4; there were 12 (42.9%) female athletes. The cohort was composed of 1 professional, 10 collegiate, 13 high school, and 4 organized amateur athletes. They demonstrated significant improvements in all recorded PROs from baseline to the minimum 5-year follow-up ( P < .001) and had high rates of achieving the minimal clinically important difference (MCID) for the mHHS (75%), NAHS (75%), HOS-SSS (67.9%), and VAS for pain (71.4%). Furthermore, 76.5% of basketball players who returned to sports were still competing at a minimum of 5 years postoperatively. When compared with a propensity-matched cohort of other cutting athletes, basketball athletes demonstrated a significantly higher acetabular labrum articular disruption (ALAD) grade ( P < .001) and trended toward a higher Outerbridge grade of the acetabular cartilage ( P = .067). Despite this, basketball players demonstrated similar preoperative, postoperative, and improvement scores in all recorded PROs. Moreover, both groups exhibited similar rates of achieving psychometric thresholds and rates of continued sports participation at minimum 5-year follow-up. Conclusion: Competitive basketball players undergoing primary hip arthroscopy for FAIS demonstrated significant improvements in all recorded PROs and high rates of continued play at a minimum 5-year follow-up. When compared with a control group of other cutting sports athletes, basketball players exhibited more severe ALAD grades intraoperatively but similar midterm outcomes.

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“…For this study, the mHHS, NAHS, HOS-SSS, VAS for pain, and patient satisfaction were measured at the preoperative and minimum 5-year postoperative time points. 2,18,37,46…”

Section: Methodsmentioning

confidence: 99%

Section: Surgical Outcome Toolsmentioning

confidence: 99%

Basketball Players Undergoing Primary Hip Arthroscopy Exhibit Higher Grades of Acetabular Cartilage Damage but Achieve Favorable Midterm Outcomes and Return to Sports Rates Comparable With a Propensity-Matched Group of Other Cutting Sports Athletes

et al. 2022

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“…Athletes who underwent a lifestyle transition (eg, graduation, aging, loss of interest) and did not attempt to RTS for reasons unrelated to their hip were not included in the RTS percentage (34 athletes). 33 Table 5 presents a summary of RTS outcomes.…”

Section: Rts and Pro Scoresmentioning

confidence: 99%

Determining Clinically Meaningful Thresholds for the Hip Outcome Score Sport-Specific Subscale in Athletes Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome

et al. 2022

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Background: The minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), substantial clinical benefit (SCB), and maximum outcome improvement (MOI) satisfaction threshold for the Hip Outcome Score Sport-Specific Subscale (HOS-SSS) have not been established in athletes undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Purpose: To determine threshold MCID, PASS, SCB, and MOI satisfaction threshold values for the HOS-SSS in athletes undergoing hip arthroscopy for FAIS at minimum 2–year follow–up. Study Design: Cohort study (Diagnosis); Level of evidence, 3. Methods: Anchor questions were administered to recreational, organized amateur, high school, college, and professional athletes who underwent primary hip arthroscopy for FAIS between May 2015 and March 2019. Patients were included if they were younger than 50 years, answered the anchor questions, and had preoperative and minimum 2–year follow–up for the HOS-SSS, modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and visual analog scale (VAS) for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center–edge angle <18°), and previous ipsilateral hip surgery or conditions. Receiver operating characteristic (ROC) analysis was used to determine PASS, SCB, and MOI satisfaction for the HOS-SSS. Two distribution methods were used to calculate MCID for HOS-SSS. Results: A total of 225 athletes who underwent primary hip arthroscopy met the inclusion criteria. Of those athletes, 200 (88.9%) who had minimum 2–year follow–up and information regarding return to sport (RTS) were included. The cohort included 124 (62.0%) women and 76 (38.0%) men with a mean ± standard deviation age of 29.4 ± 10.4 years, body mass index of 25.6 ± 5.4, and follow–up of 29.5 ± 5.1 months. Athletes experienced significant improvements in HOS-SSS, mHHS, NAHS, and VAS from preoperative to latest postoperative follow–up ( P < .001), and mean satisfaction was 8.2. The RTS rate was 83.7%. ROC analysis determined that the PASS, MOI satisfaction threshold, SCB absolute score, SCB change score, and MCID (baseline/change score methods) for the HOS-SSS were 77.0, 44.6%, 92.7, 30.6, and 10.6, respectively, with athletes achieving thresholds at high rates (80.0%, 80.5%, 45.0%, 54.0%, and 79.5%, respectively). Conclusion: This study identified values for the HOS-SSS that can be used to define clinically meaningful outcomes in athletes after primary hip arthroscopy for FAIS. The PASS, MOI satisfaction threshold, SCB absolute score, SCB change score, and MCID for the HOS-SSS at minimum 2–year follow–up in athletes after primary hip arthroscopy were 77.0, 44.6%, 92.7, 30.6, and 10.6, respectively.

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“…Weber et al recently conducted a systematic review to evaluate why athletes may fail to return to sport. 5 In the 20 included 7 In this study, the authors identified a cohort of patients that did not attempt a RTS due to reasons other than their hip. They retrospectively reviewed their prospectively collected data reporting on 2-and 5-year PROMs, along with rates at which they surpassed the minimum clinically important difference (MCID).…”

Section: See Related Article On Page 1879mentioning

confidence: 99%

Editorial Commentary: Failure to Return to Sport, or Rather a Failure to Attempt a Return After Hip Arthroscopy Is Not Correlated With Poor Clinical Outcome: The Devil Is in the Details

Degen¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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High-Level Athletes Who Did Not Return to Sport for Reasons Unrelated to Their Hip Achieve Successful Midterm Outcomes With a Benchmarking Against High-Level Athletes Who Returned to Sport

Cited by 9 publications

References 48 publications

Basketball Players Undergoing Primary Hip Arthroscopy Exhibit Higher Grades of Acetabular Cartilage Damage but Achieve Favorable Midterm Outcomes and Return to Sports Rates Comparable With a Propensity-Matched Group of Other Cutting Sports Athletes

Basketball Players Undergoing Primary Hip Arthroscopy Exhibit Higher Grades of Acetabular Cartilage Damage but Achieve Favorable Midterm Outcomes and Return to Sports Rates Comparable With a Propensity-Matched Group of Other Cutting Sports Athletes

Determining Clinically Meaningful Thresholds for the Hip Outcome Score Sport-Specific Subscale in Athletes Undergoing Hip Arthroscopy for Femoroacetabular Impingement Syndrome

Editorial Commentary: Failure to Return to Sport, or Rather a Failure to Attempt a Return After Hip Arthroscopy Is Not Correlated With Poor Clinical Outcome: The Devil Is in the Details

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