Abstract
Objectives:
(1) To report mid-term outcomes of HLA following primary hip arthroscopy and (2) to compare their results to a propensity-matched cohort of NA patients.
Methods:
Data were prospectively collected and retrospectively reviewed from February 2008 to November 2015 for HLA (professional, college, or high school) who underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS). HLA were included if they had preoperative, minimum 2-year, and minimum 5-year follow-up data for the Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), and Hip Outcome Score Sports-Specific Subscale (HOS-SSS). Radiographic and intraoperative findings, surgical procedures, patient-reported outcome scores (PROs), the patient acceptable symptomatic state (PASS), the minimal clinically important difference (MCID) and the return to play were reported. The HLA study group was propensity-matched to a control group of NA patients for comparison.
Results:
A total 65 HLA (67 hips) were included in the final analysis with mean follow-up time of 74.6 ± 16.7 months. HLA showed significant improvement in all PROs recorded, achieved high rates of MCID and PASS for mHHS (74.6% and 79.4% respectively) and HOS-SSS (67.7% and 66.1% respectively), and returned to sport at high rates (80.4%). When compared to the propensity-matched NA control group, HLA reported higher baseline but comparable postoperative scores for the mHHS and NAHS. HLA patients achieved MCID and PASS for mHHS at similar rates as NA patients, but they achieved PASS for HOS-SSS at higher rates which trended toward statistical significance (66.1% vs 48.4%; P = .07). NA underwent revision arthroscopic surgery at similar rates compared to HLA patients (14.9% vs 9.0%; P = .424).
Conclusions:
Primary hip arthroscopy results in favorable mid-term outcomes in HLA. When compared to a propensity-matched NA control group, HLA demonstrated a tendency toward higher rates of achieving PASS for HOS-SSS but similar arthroscopic revision rates at minimum 5-year follow-up.
Patient Selection Flowchart. HLA, High-Level Athletes; NA= Non-Athletes
Patient-Reported Outcomes Scores for High Level Athletes (HLA) group and Non-Athletes (NA) group ait the preoperative, minimum 2-year and rninimum 5-year time points. * indicates statistically significant | difference between groups.
MCID and PASS of the Cohorts After Propensity Score Matchinsa
