Midterm Outcomes and Return to Sports Among Athletes Undergoing Hip Arthroscopy

Perets, Itay; Craig, Matthew; Mu, Brian; Maldonado, David R.; Litrenta, Jody; Domb, Benjamin G.

doi:10.1177/0363546518765969

Cited by 46 publications

(52 citation statements)

References 21 publications

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“…13 We believe that labral repair is the gold standard for labral tear treatment, as studies have shown excellent outcomes and high rates of return to sport after labral repair. 19,24,31,33,34,40 However, in cases of irreparable, nonviable, or calcified labra, labral reconstruction has recently emerged as a viable procedure. Literature shows that in these cases, labral reconstruction can restore labral function and is preferred over debridement or excision.…”

Section: The Orthopaedic Journal Of Sports Medicinementioning

confidence: 99%

“…Literature shows favorable VAS, patient satisfaction, and return to sport after labral repair. 4,19,31,33 Furthermore, labral reconstruction is among the most challenging procedures in hip arthroscopy, as evidenced by the handful of surgeons currently performing labral reconstructions. 18,35,36,44,46 This study has several strengths.…”

Section: The Orthopaedic Journal Of Sports Medicinementioning

confidence: 99%

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Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Maldonado

Chen

Yelton

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population. Purpose: To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively analyzed for patients who underwent an arthroscopic labral reconstruction between August 2012 and December 2017. Patients were included if they identified as an athlete (high school, college, recreational, or amateur); had follow-up on the following patient-reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS); and completed a return-to-sport survey at 1 year postoperatively. Patients were excluded if they underwent any previous ipsilateral hip surgery, had dysplasia, or had prior hip conditions. The proportions of patients who achieved the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for mHHS and HOS-SSS were calculated. Statistical significance was set at P = .05. Results: There were 32 (14 females) athletes who underwent primary arthroscopic labral reconstruction during the study period. The mean age and body mass index of the group were 40.3 years (range, 15.5-58.7 years) and 27.9 kg/m2 (range, 19.6-40.1 kg/m2), respectively. The mean follow-up was 26.4 months (range, 12-64.2 months). All patients demonstrated significant improvement in mHHS, NAHS, HOS-SSS, and VAS ( P < .001) at latest follow-up. Additionally, 84.4% achieved MCID and 81.3% achieved PASS for mHHS, and 87.5% achieved MCID and 75% achieved PASS for HOS-SSS. VAS pain scores decreased from 4.4 to 1.8, and the satisfaction with surgery was 7.9 out of 10. The rate of return to sport was 78%. Conclusion: At minimum 1-year follow-up, primary arthroscopic labral reconstruction, in the setting of femoroacetabular impingement syndrome and irreparable labral tears, was associated with significant improvement in PROs in athletic populations. Return to sport within 1 year of surgery was 78%.

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Section: The Orthopaedic Journal Of Sports Medicinementioning

confidence: 99%

Section: The Orthopaedic Journal Of Sports Medicinementioning

confidence: 99%

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Maldonado

Chen

Yelton

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…3,6,38 However, only a few studies have used patient-reported outcome measures (PROMs) to present the results, 10,36,37,39 and the reports on the long-or midterm outcome in this patient category are limited. 9,33 Nevertheless, arthroscopic treatment in athletes presenting with FAIS is increasing, and studies suggest that high-level athletes will improve their hip function and have a high rate of return to preinjury activity levels. 2,4,7,8 Follow-up after hip surgery generally includes PROMs.…”

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confidence: 99%

Five-Year Outcomes After Arthroscopic Surgery for Femoroacetabular Impingement Syndrome in Elite Athletes

et al. 2020

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Background: Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and disability in athletes. Arthroscopic treatment for FAIS is well-established; however, the long-term results in elite athletes are limited. Purpose: To evaluate outcomes 5 years after arthroscopic treatment for FAIS in elite athletes. Study Design: Case series; Level of evidence, 4. Methods: Elite athletes undergoing arthroscopic treatment for FAIS with a minimum 5-year follow-up were included. They were prospectively followed up with patient-reported outcome measures. An elite athlete was defined as having a Hip Sports Activity Scale (HSAS) level of 7 or 8 before the onset of symptoms. Preoperatively and 5 years after surgery, all athletes completed a web-based questionnaire, including the Copenhagen Hip and Groin Outcome Score (comprising 6 subscales), the EQ-5D and EQ-VAS (European Quality of Life–5 Dimensions Questionnaire and European Quality of Life–Visual Analog Scale), iHOT-12 (International Hip Outcome Tool), a visual analog scale for hip function, and the HSAS. Moreover, patients reported their overall satisfaction with their hip function. Preoperative measurements were compared with the 5-year follow-up. Results: A total of 64 elite athletes (52 men, 12 women) with a mean ± SD age of 24 ± 6 years were included. On average, patients reported a statistically significant and clinically relevant improvement from preoperative patient-reported outcome measures to the 5-year follow-up ( P < .0003), Copenhagen Hip and Groin Outcome Score subscales (symptoms, 51.7 vs 71.9; pain, 61.0 vs 81.1; function of daily living, 67.1 vs 83.6; function in sports and recreation, 40.0 vs 71.5; participation in physical activity, 25.0 vs 67.4; hip and groin–related quality of life, 34.4 vs 68.0), EQ-5D (0.60 vs 0.83), EQ-VAS (66.1 vs 76.7), and iHOT-12 (40.0 vs 68.8). At the 5-year follow-up, 90.5% reported satisfaction with their overall hip function. In total, 54% still participated in competitive sports (HSAS, 5-8) at follow-up, while 77% had decreased their level. Older patients and patients with longer duration of symptoms reported a significantly lower level of sports activity (HSAS, 0-4; P < .009). Conclusion: Arthroscopic treatment for FAIS in elite athletes results in a statistically significant and clinically relevant improvement regarding symptoms, hip function, quality of life, and pain 5 years after surgery. Approximately half of the cohort was still in competitive sports at follow-up, yet 77% had decreased their level of sports. Nine of 10 patients were satisfied with their surgery.

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“…All patients participated in the American Hip Institute Hip Preservation Registry. While the present study represents a unique analysis, data on some patients in this study has been reported in other studies [11,12]. All data collection received Institutional Review Board approval.…”

Section: Patient Selection Criteriamentioning

confidence: 95%

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up

Maldonado

Yelton

Rosinsky

et al. 2020

BMC Musculoskelet Disord

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Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting patient reported outcomes (PROs) and return to sport (RTS) in competitive or recreational tennis players after arthroscopic hip surgery. Therefore, the purpose of the present study was to (1) report minimum fiveyear PROs and RTS in tennis players who underwent arthroscopic hip surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement and labral tears between March 2009 and January 2014 and who played tennis within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% RTS rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS.

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Midterm Outcomes and Return to Sports Among Athletes Undergoing Hip Arthroscopy

Abstract: Midterm results of hip arthroscopy in athletes are shown to be safe and favorable. Most athletes return to sports and continue to play after 5 years with the same or higher ability.

Cited by 46 publications

References 21 publications

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

Five-Year Outcomes After Arthroscopic Surgery for Femoroacetabular Impingement Syndrome in Elite Athletes

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up

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