Patient-Reported Outcome Scores and Rate of Return to Sport After Hip Arthroscopic Surgery: A Sex-Based Comparison in Professional and Collegiate Athletes

Abstract

Background: No studies have compared outcomes and return to sport (RTS) after hip arthroscopic surgery between matched groups of male and female athletes with a minimum 2-year follow-up. Purpose: (1) To report minimum 2-year postoperative patient-reported outcome (PRO) scores and the RTS rate for elite female athletes undergoing hip arthroscopic surgery for femoroacetabular impingement (FAI) and (2) to compare clinical results with a matched control group of elite male athletes. Study Design: Cohort study; Level of evidence, 3. Methods: Data on all consecutive female athletes who underwent primary hip arthroscopic surgery performed at our institution between March 2009 and July 2018 were collected. Patients were eligible if they underwent hip arthroscopic surgery for labral tears or FAI and participated in collegiate or professional athletics within 1 year of surgery. Minimum 2-year postoperative PRO scores were collected for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain as well as RTS status. The percentages of patients achieving the minimal clinically important difference (MCID) and patient acceptable symptomatic state were recorded. These patients were matched to elite male athletes for comparison. Results: A total of 73 female hips were included, with a mean follow-up of 65.1 ± 27.9 months. They demonstrated a significant improvement from preoperatively to latest follow-up on the mHHS, NAHS, HOS-SSS, and VAS ( P < .05). When outcomes were compared with a control group of male athletes, female athletes demonstrated lower preoperative scores, similar postoperative scores, and a significantly greater magnitude of improvement (delta value) on the mHHS, NAHS, and VAS. Female athletes also achieved the MCID at higher rates than did male athletes for the HOS-SSS (85.1% vs 70.0%, respectively; P = .035) and NAHS (79.1% vs 62.9%, respectively; P = .037). RTS rates among patients who attempted were similar between the 2 groups (female: 75.4%; male: 83.1%; P = .409). Conclusion: Elite female athletes undergoing primary hip arthroscopic surgery for FAI demonstrated a significant improvement in PRO scores and a high RTS rate. Female athletes exhibited a greater improvement in PRO scores (mHHS, NAHS, VAS) and achieved the MCID (HOS-SSS, NAHS) at higher rates compared with a control group of male athletes.

Sex-Based Differences in Athletes Undergoing Primary Hip Arthroscopy With Labral Reconstruction: A Propensity-Matched Analysis With Minimum 2-Year Follow-up

“…Shibata et al 55 performed a nonmatched comparison of elite-level male and female athletes and demonstrated excellent RTS rates in both male and female athletes. Similarly, Glein et al 21 also demonstrated favorable outcomes at a minimum 2-year follow-up in a cohort of elite female athletes undergoing primary hip arthroscopy; however, in their study, female athletes demonstrated statistically significantly greater improvement in PROs compared with male patients. The outcomes in the present study provide further evidence to support similar outcomes in male and female athletes undergoing hip arthroscopy with labral reconstruction despite the preoperative differences present in bony morphology.…”

“…Recent studies have established favorable outcomes in athletes undergoing labral reconstruction, but no studies have evaluated sex-based differences in presentation and outcomes of these athletes. 21 , 28 …”

“…Recent studies have established favorable outcomes in athletes undergoing labral reconstruction, but no studies have evaluated sex-based differences in presentation and outcomes of these athletes. 21,28 The purpose of this study was to report sex-based differences in clinical characteristics, patient-reported outcomes (PROs), and return-to-sports (RTS) rates in patients undergoing primary hip arthroscopy with labral reconstruction. We hypothesized that male and female patients undergoing primary hip arthroscopy with labral reconstruction (1) would have different clinical conditions and require different surgical procedures and (2) would both experience favorable outcomes after hip arthroscopy.…”

Revision Hip Arthroscopy With Labral Reconstruction for Irreparable Labral Tears in Athletes: Minimum 2-Year Outcomes With a Benchmark Control Group

“…Hip arthroscopy is being performed increasingly frequently in athletes and has shown favorable outcomes and high rates of return to sports (RTS). 7,14,27,33,34 Labral function restoration and adequate treatment of femoroacetabular impingement syndrome (FAIS) are critical components of successful outcomes after primary hip arthroscopy. 3,57,59 In cases of irreparable labral tears, labral reconstruction has shown promising short–term outcomes and RTS in athletes in the primary setting.…”

Elite Female Athletes Demonstrate a Comparable Improvement in Midterm Patient-Reported Outcome Scores and Rate of Return to Sport Compared With Elite Male Athletes After Hip Arthroscopic Surgery: A Sex-Based Comparison in Professional and Collegiate Athletes

“…38,46,63 Although recent studies have established favorable outcomes in athletes at midterm follow-up, to our best knowledge, there are no studies that have evaluated sex-based differences in the presentation and outcomes of these athletes. 25,33,43,57,58 The purpose of this study was (1) to report minimum 5year patient-reported outcome (PRO) scores as well as RTS and continuation of sport (CTS) rates for elite female athletes undergoing hip arthroscopic surgery for FAIS and (2) to compare clinical results with those of a matched control group of elite male athletes. It was hypothesized that elite female athletes would achieve favorable outcomes at midterm follow-up and that these outcomes would be similar to those of a control group of elite male athletes.…”