PMID- 37377182
OWN - NLM
STAT- Publisher
LR  - 20230628
IS  - 1941-0921 (Electronic)
IS  - 1941-0921 (Linking)
DP  - 2023 Jun 28
TI  - High-Level Competitive Athletes Who Undergo Hip Arthroscopy Demonstrate Durable 
      5-Year Outcomes and Lower Subjective Pain: A Propensity-Matched Analysis.
PG  - 19417381231183658
LID - 10.1177/19417381231183658 [doi]
AB  - BACKGROUND: Hip arthroscopy (HA) has been proven to be an effective treatment for 
      femoroacetabular impingement syndrome (FAIS) in both competitive athletes (CA) 
      and non-CA at short-term follow-up. However, there is a paucity of literature 
      investigating midterm outcomes comparing athletes with Controls. HYPOTHESIS: 
      Athletes would have significant improvements at 5 years, with favorable outcomes 
      compared with their control counterparts, and high return-to-sport (RTS) rate. 
      STUDY DESIGN: Propensity-matched retrospective comparative cohort study. LEVEL OF 
      EVIDENCE: Level 3. METHODS: CAs who underwent primary HA for FAIS from January 1, 
      2012 to April 30, 2017 were identified and propensity matched on a 1:4 basis to 
      Controls by age, sex, and body mass index (BMI). Patient-reported outcomes (PROs) 
      were collected preoperatively and at 5 years. Minimal clinically important 
      differences (MCID) and patient acceptable symptom states (PASS) rates were 
      calculated using previously published thresholds. Rate and duration of RTS were 
      collected retrospectively. RESULTS: A total of 57 high-level CA (33 female, 24 
      male; age, 21.7 +/- 4.2 years; BMI, 23.1 +/- 2.8 kg/m(2)) were propensity matched to 
      228 Controls (132 female, 96 male; P > 0.99; age, 23.3 +/- 5.8 years; P = 0.02; 
      BMI, 23.8 +/- 4.3 kg/m(2), P = 0.24). Significant differences were observed in 
      preoperative Hip Outcome Score Sports Specific and Activities of Daily Living 
      (HOS-ADL) subscales (CA, 74.9 +/- 13.7 vs Controls, 66.4 +/- 18.4; P = 0.01) and 
      modified Harris Hip Score (mHHS) (CA, 64.7 +/- 12.9 vs Controls, 59.7 +/- 14.3; P = 
      0.04). Both groups demonstrated significant postoperative improvements in all 
      outcome scores measured (P </= 0.01). At 5 years postoperatively, there were 
      significant differences between groups in Visual Analog Scale (VAS) Pain (CA, 
      17.3 +/- 17.6 vs Controls, 24.7 +/- 25.9; P = 0.02). There were no significant 
      differences in achieving MCID or PASS. Athletes RTS at a median of 25.2 weeks (Q1 
      22.4-Q3 30.7) with an overall RTS rate of 90%. Similar rates of revision were 
      seen between CA patients (n = 3; 5.3%) and Control patients (n = 9; 3.9%) (P = 
      0.66). CONCLUSION: CAs demonstrated significant and durable improvements in PROs 
      as well as high MCID and PASS achievement rates after primary HA, which were 
      comparable with those of Controls. Clinicians should be aware that CA patients 
      demonstrate higher preoperative mHHS and HOS-ADL scores than Controls and achieve 
      lower average self-reported pain at 5 years postoperatively. In addition, CA 
      patients demonstrate high rates of RTS at a median of 25 weeks postoperatively. 
      CLINICAL RELEVANCE: This study provides insight into CA versus Control PROs and 
      rates of achieving MCID and PASS at a midterm follow-up of 5 years. Furthermore, 
      this study offers perception into RTS rate, both in general as well as specified 
      to individualized sports.
FAU - Fenn, Thomas W
AU  - Fenn TW
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois.
FAU - Horner, Nolan S
AU  - Horner NS
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois.
FAU - Ingawa, H Sadiyya
AU  - Ingawa HS
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois.
FAU - Hevesi, Mario
AU  - Hevesi M
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois.
FAU - Beals, Corey
AU  - Beals C
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois.
FAU - Nho, Shane J
AU  - Nho SJ
AD  - Section of Young Adult Hip Surgery, Division of Sports Medicine, Department of 
      Orthopedic Surgery, Rush Medical College of Rush University, Rush University 
      Medical Center, Chicago, Illinois.
LA  - eng
PT  - Journal Article
DEP - 20230628
PL  - United States
TA  - Sports Health
JT  - Sports health
JID - 101518422
SB  - IM
OTO - NOTNLM
OT  - athletes
OT  - femoroacetabular impingement
OT  - hip arthroscopy
OT  - return to sport
EDAT- 2023/06/28 13:09
MHDA- 2023/06/28 13:09
CRDT- 2023/06/28 07:33
PHST- 2023/06/28 13:09 [medline]
PHST- 2023/06/28 13:09 [pubmed]
PHST- 2023/06/28 07:33 [entrez]
AID - 10.1177/19417381231183658 [doi]
PST - aheadofprint
SO  - Sports Health. 2023 Jun 28:19417381231183658. doi: 10.1177/19417381231183658.