Results of hip arthroscopy in elite level water polo players with femoroacetabular impingement: return to play and patient satisfaction

Abstract

Water polo places significant stress on the hip joint requiring repetitive hip flexion and rotation to elevate the body out of water for passing, shooting and blocking. Femoroacetabular impingement (FAI) is common in water polo athletes; however, no study to date has investigated the results of hip arthroscopy in this patient population. The purpose of this study was to determine return to play rates and satisfaction following hip arthroscopy for FAI in a cohort of elite level water polo players. A retrospective review of our surgical database was performed. Collegiate water polo players with clinical and radiographic FAI who underwent hip arthroscopy were identified. Pre- and post-operative modified Harris hip scores (mHHSs) were obtained. Patient surveys were administered to determine return to play rates, level of return to play, timing of return and patient satisfaction. A Wilcoxon ranked sum test was performed to compare pre- and post-operative outcome scores. Ten patients met inclusion criteria. Average age was 19.5 years old (SD ±1.08). All patients were male Division 1 collegiate water polo players. Median mHHS improved from 66.0 (SD ±7.9) pre-operatively to 89.5 (SD ±3.2) at average 1.6 years (range: 0.4–3.6 years) post-operatively. Patient survey responses demonstrated a 100% return to water polo and 100% return to the same level of play (NCAA Division 1) at mean 5.75 months (SD ±1.8). All patients (10/10) reported being satisfied with their surgical result. Our study results, suggest that return to sport rates and patient satisfaction are high in water polo players who undergo hip arthroscopy for FAI.

‘Mini-Max’ knotless acetabular labrum repair: repair construct rationale and allocation in a consecutive case series with minimum 1-year clinical outcomes

“…The postoperative improvement after labral repair in this cohort correlates with other studies reporting on PROs after arthroscopic labral repair procedures [ 11 , 22 , 26–28 ]. Jackson et al.…”

“…During the last decade, arthroscopic procedures for acetabular labrum repair have demonstrated improved clinical outcomes and joint space preservation at short-term follow-up [ 22 , 26–28 ]. Restoring the labrum as close to its original anatomy is essential in order to preserve and reestablish the labrum’s function.…”

The clinical outcomes of arthroscopic hip labral repair: a comparison between athletes and non-athletes

“…Ramos et al. [ 22 ] demonstrated that all the elite-level water polo players who underwent hip arthroscopy for FAI returned to the same level of play and were highly satisfied. Sochacki et al.…”

Injuries Affecting Intercollegiate Water Polo Athletes: A Descriptive Epidemiologic Study

“…FAI is thought to arise from repetitive hip loading at extreme ranges of motion, especially hip flexion and internal rotation, which is seen during water treading, in skeletally immature individuals, causing bony remodeling. 28 Despite previous reports showing great surgical outcomes for both water polo and swimming athletes, 9,23 the high burden of surgery and missed playing time associated with FAI makes this injury a critical subject of future research. For example, such research could focus on how early sport specialization and high training volume, which have been shown to increase injury rates and missed time among NCAA athletes, 1 may influence rates of FAI.…”