Predictors of Clinical Outcomes After Hip Arthroscopy: 5-Year Follow-up Analysis of 1038 Patients

2020 ◽  
Vol 49 (1) ◽  
pp. 112-120 ◽  
Author(s):  
Benjamin G. Domb ◽  
Sarah L. Chen ◽  
Cammille C. Go ◽  
Jacob Shapira ◽  
Philip J. Rosinsky ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Predictive Factors ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Joint Space ◽  
Harris Hip Score ◽  
Bivariate Analysis ◽  
Inclusion Criteria ◽  
Modified Harris Hip Score

Background: Although hip arthroscopy has been shown to have favorable results, there is a paucity of literature describing predictive factors of 5-year clinical outcomes. Purpose: To identify predictive factors of midterm outcomes after hip arthroscopy in a cohort of 1038 patients whose outcomes at minimum 2-year follow-up were previously reported. In addition, to provide a comparison of short- and midterm predictive factors in outcome measures after hip arthroscopy. Study Design: Case-control study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing hip arthroscopy between February 2008 and June 2012. Patients were included if they had minimum 5-year follow-up on 2 patient-reported outcomes: Nonarthritic Hip Score (NAHS) and modified Harris Hip Score. Patients were excluded if they had any previous ipsilateral hip conditions. Using bivariate and multivariate analyses, we analyzed the effect of 36 pre- and intraoperative variables on the NAHS, modified Harris Hip Score, and conversion to total hip arthroplasty. Results: A total of 1038 patients met the inclusion criteria for the 2-year study, and 860 met our listed inclusion criteria for the 5-year study. The mean follow-up time was 62.0 months (range, 60.0-120.0 months). The bivariate analysis identified 10 variables (4 categorical and 6 continuous) that were predictive of 5-year postoperative NAHS. For the multivariate analysis, 7 variables were identified as being significant: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. These 7 variables were also predictive in the bivariate analysis. Age, BMI, revision hip arthroscopy, Tönnis grade, sex, trochanteric bursectomy, femoral head cartilage damage, and acetabular inclination were significant predictors of conversion to total hip arthroplasty. Conclusion: This study reports favorable midterm clinical outcomes in the largest cohort of hip arthroscopies with minimum 5-year follow-up in the literature to date. Seven variables were identified as being significant predictors of postoperative NAHS in the bivariate and multivariate analyses: preoperative NAHS, BMI, age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. Of these, preoperative NAHS, BMI, age, and revision hip arthroscopy were predictive of 2- and 5-year postoperative NAHS. These predictive factors may prove useful to clinicians in determining indications for hip arthroscopy and counseling patients on its expected outcomes.

scholarly journals Predictors of Clinical Outcomes After Hip Arthroscopy: 5 Year Follow- Up Analysis of 1038 Patients

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0038
Author(s):  
Benjamin Domb ◽  
Cammille Go ◽  
David Maldonado ◽  
Sarah Chen ◽  
Ajay Lall
Keyword(s):  
Body Mass Index ◽  
Multivariate Analysis ◽  
Clinical Outcomes ◽  
Body Mass ◽  
Predictive Factors ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Joint Space ◽  
Bivariate Analysis

Objectives: Identify predictive factors of midterm outcomes after hip arthroscopy in a cohort of 1038 patients, whose outcomes at minimum 2-year follow-up have previously been reported. In addition, to provide a comparison of short-term and midterm predictive factors in outcome measures following hip arthroscopy. Methods: Data were prospectively collected and retrospectively reviewed on all patients undergoing hip arthroscopy between February 2008 and June 2012. Patients were included if they had minimum 5-year follow-up on 3 patient reported outcomes: Nonarthritic Hip Score (NAHS), modified Harris Hip Score (mHHS), and Hip Outcome Score-Sport Specific Subscale (HOS-SSS). Patients were excluded if they had any prior ipsilateral hip conditions. Using bivariate and multivariate analyses, we analyzed the effect of 36 preoperative and intraoperative variables on NAHS. Results: A total of 1038 patients met our listed inclusion and exclusion criteria, with a mean follow-up time of 62.0 months (range, 60.0 - 120.0 months). The bivariate analysis identified 11 variables (4 categorical and 7 continuous) that were predictive of 5-year postoperative NAHS. For the multivariate analysis, 7 variables were identified as being significant: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. These 7 variables were also predictive in the bivariate analysis. Conclusion: This study reports favorable midterm clinical outcomes in the largest cohort of hip arthroscopies with minimum 5-year follow up in the literature to date. Seven variables were identified as being significant predictors in both the bivariate and multivariate analysis: preoperative NAHS, body mass index (BMI), age, lateral joint space, alpha angle, revision hip arthroscopy, and acetabular microfracture. Of these, preoperative NAHS, BMI, age, and revision hip arthroscopy were predictive of both 2-year and 5-year postoperative NAHS. These predictive factors may prove useful to clinicians in determining indications for hip arthroscopy and counseling patients on its expected outcomes.

scholarly journals Outcomes of arthroscopic femoroplasty in patients with cam lesions: Minimum 2-year follow-up

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902094204
Author(s):  
Yong-Chan Ha ◽  
Jae-Young Lim ◽  
Yoo-Sun Won ◽  
Young-Kyun Lee ◽  
Kyung-Hoi Koo ◽  
...  
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Visual Analog Scale Score ◽  
Harris Hip Score ◽  
Preoperative Pain ◽  
Military Population ◽  
Modified Harris Hip Score

Purpose: Successful arthroscopic femoroplasty in patients with cam lesions have been reported in Western countries in the last two decades. However, the outcomes after arthroscopic femoroplasty in Asia have thus far only been reported in patients with borderline dysplasia and in the military population. This retrospective study was designed to evaluate the short-term clinical outcomes and radiologic outcomes after hip arthroscopy in patients with cam-type femoroacetabular impingement (FAI) at a minimum postoperative follow-up of 2 years. Methods: From January 2013 to December 2016, 204 hip arthroscopy procedures were performed. Of these cases, 62 patients (73 hips) underwent hip arthroscopy for cam-type FAI. Results: Of the 73 hips, 65 (89.0%) achieved gratified reduction or elimination of preoperative pain. The clinical outcomes showed improvement in scores from before surgery to the last follow-up: 67.1 ± 15.0 to 90.2 ± 6.3 for the modified Harris hip score ( p < 0.001), 4.7 ± 2.5 to 7.1 ± 1.4 for the University of California Los Angeles score ( p < 0.001), and 7.4 ± 1.9 to 1.8 ± 1.5 for the visual analog scale score ( p < 0.001). In radiologic assessments, significant improvement was observed in the alpha angle from a mean 60.9° to 49.5° ( p < 0.001) and in the head–neck offset from a mean of 3.3 mm to 6.3 mm ( p < 0.001). Of the 73 hips, 65 (89.0%) achieved satisfactory reduction or elimination of preoperative pain. In subgroup analysis for the sufficiency of femoroplasty (alpha angle < 55°), the clinical outcomes were not different between the two groups. Conclusion: Arthroscopic femoroplasty resulted in an 89% satisfaction at the 2-year follow-up. Therefore, hip arthroscopic femoroplasty might be an excellent alternative to open surgery and offers a greater probability of good to excellent results.

Predictors of Clinical Outcomes After Hip Arthroscopy: A Prospective Analysis of 1038 Patients With 2-Year Follow-up

2018 ◽  
Vol 46 (6) ◽  
pp. 1324-1330 ◽  
Author(s):  
Benjamin G. Domb ◽  
Timothy J. Martin ◽  
Chengcheng Gui ◽  
Sivashankar Chandrasekaran ◽  
Carlos Suarez-Ahedo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Predictive Factors ◽  
Hip Arthroscopy ◽  
Multivariate Analyses ◽  
Harris Hip Score ◽  
Duration Of Symptoms ◽  
Outcome Instrument ◽  
Outcome Score ◽  
Patient Reported

Background: As hip arthroscopy has expanded in popularity and volume, more information is needed about indications for the procedure and the predictive factors of clinical outcomes. Purpose: To evaluate clinical outcomes of hip arthroscopy in a prospective study and to analyze the cohort to identify factors that are predictive of improvement. Study Design: Case-control study; Level of evidence, 3. Methods: Data were collected prospectively on all patients undergoing hip arthroscopy between February 2008 and June 2012. We included all patients undergoing hip arthroscopy who agreed to participate and who completed 4 patient-reported outcome (PRO) instruments at a minimum 2-year follow-up: the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), and Hip Outcome Score–Sport-Specific Subscale. The NAHS was selected as our primary outcome instrument. All patients with any previous hip conditions were excluded. We analyzed 34 preoperative and intraoperative variables using bivariate and multivariate analyses compared with NAHS. Results: The cohort consisted of 1038 patients with a mean follow-up of 30.1 months (range, 24.0-61.2 months). Mean age was 36.4 years (range, 13.2-76.4 years). All postoperative PRO scores showed significant improvement ( P < .001) at 2 years compared with preoperative scores. Bivariate analysis identified 15 variables (7 categorical and 8 continuous) and multivariate analysis identified 10 variables that were predictive of 2-year postoperative NAHS. Preoperative NAHS, preoperative HOS-ADL, preoperative mHHS, age, duration of symptoms, body mass index (BMI), and revision hip arthroscopy were identified as predictive factors in both bivariate and multivariate analyses. The predictive value of preoperative NAHS was accentuated for patients with higher BMI. Conclusion: This study reports favorable clinical outcomes in the largest cohort of hip arthroscopies with a minimum 2-year follow-up in the literature to date. Factors identified as predictive in both bivariate and multivariate analyses included preoperative NAHS, HOS-ADL, and mHHS; age; duration of symptoms; BMI; and revision hip arthroscopy. These predictive factors may be useful to the clinician in determining prognosis and operative indications for hip arthroscopy.

scholarly journals Clinical Outcomes after Arthroscopic Repair of Gluteus Medius with a Two-year Minimum Follow-up

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0044
Author(s):  
David Bloom ◽  
David Kirby ◽  
Thomas Youm ◽  
Jordan Fried
Keyword(s):  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Hip Arthroscopy ◽  
Gluteus Medius ◽  
Arthroscopic Repair ◽  
Harris Hip Score ◽  
Inclusion Criteria ◽  
Partial Group ◽  
Patient Reported

Objectives: Hip arthroscopy has replaced the need for many open surgeries including repairs of gluteus medius tendon tear. There are only a few studies that have analyzed patient reported outcomes at 2 years for arthroscopic gluteus medius tendon repair. The purpose of the current study is to evaluate clinical outcomes in patients who underwent arthroscopic gluteus medius repair with at least 2 year follow-up. Methods: This was a single-center, retrospective IRB approved study. Between August 2010 and August 2016, patients who underwent hip arthroscopy with gluteus medius repair by a single surgeon were evaluated at baseline and two year follow-up via Modified Harris Hip Score (MHHS) and Non-arthritic Hip Score (NAHS). Inclusion criteria included all patients who received arthroscopic repair of the full or partial thickness tears of the gluteus medius tendon and had a minimum follow up of at least two years. Paired t-test was used for statistical comparison between baseline and follow-up for each respective outcome score and group. Results: 20 hips were evaluated, met the inclusion criteria and separated based on partial (group one) or full thickness tear (group two). The study population comprised of 15 (79%) females and 4 (21%) males. Group one presented with a mean age of 54.8 ± 11.3 years and an average BMI of 25.1 ± 4.0. Group two presented with a mean age of 46 ± 11.4 and an average BMI of 25.5 ± 4.0. Patients in group one reported an average preoperative MHHS and NAHS of 33.6 ± 11.3 and 40.4 ± 14.9, respectively. At 2 year follow-up, an average MHHS and NAHS of 72.9 ± 22.9 and 77.2 ± 19.7 was reported, respectively. Patients in group two reported an average preoperative MHHS and NAHS of 43.8 ± 14.7 and 46.4 ± 8.3, respectively. At 2 year follow-up, an average MHHS and NAHS of 80.1 ± 8.5 and 79.5 ± 10.1, respectively. There was significant clinical improvement at the 2 year follow-up, relating to both outcome measures in each subject group (p<0.0004). Conclusions: After a minimum of two years for follow-up, arthroscopic repair of gluteus medius tears proves to be an effective approach and treatment. In the future, studies looking at longer follow-up time would help determine if the current approach maintains long-term clinical improvement.

scholarly journals Hip arthroscopy has good clinical outcomes in the treatment of osteoid osteoma of the acetabulum

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Guanying Gao ◽  
Ruiqi Wu ◽  
Rongge Liu ◽  
Yingfang Ao ◽  
Jianquan Wang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Osteoid Osteoma ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Harris Hip Score ◽  
Center Edge ◽  
Patient Reported ◽  
The Mean ◽  
Outcome Tool

Abstract Background Osteoid osteoma (OO) of the acetabulum is a relatively rare disease. However, the the clinical outcomes of hip arthroscopy for treatment of OO of the acetabulum are still uncertain. Methods We evaluated consecutive patients who were diagnosed with OO of the acetabulum and who underwent hip arthroscopy at our hospital between January 2013 and March 2020. All patients underwent a preoperative physical examination. Preoperative supine anteroposterior hip radiography, cross-table lateral radiographs, computed tomography (CT), and magnetic resonance imaging were performed in all patients. The alpha angle and lateral center-edge angle were measured before surgery. Supine anteroposterior hip radiography and CT were performed in all patients postoperatively. Preoperative patient-reported outcomes (PROs), including Visual Analog Scale (VAS), the International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS), and PROs at final follow-up were evaluated. Results A total of 6 patients (mean age, 18.7 years; age range, 6–31 years; 5 males and 1 females) were included in this study. The average follow-up period after surgery was 28.3 months (range, 6–90 months). Before surgery, the mean mHHS was 45.2 ± 10.5 (range, 33–56), the mean iHOT-12 was 33.3 ± 14.5 (range, 13–49), and mean VAS was 8.2 ± 1.0 (range, 7–9). At one month after surgery, mean mHHS was 78.7 ± 1.9 (range, 77–81), iHOT-12 was 71.0 ± 4.5 (range, 68–80), and mean VAS was 0. At the final post-operative follow-up, mean mHHS was 89.2 ± 2.1 (range, 86–91), iHOT-12 was 93.5 ± 5.0 (range, 88–98), and mean VAS was 0. All results, except VAS between one month after surgery and at final follow-up, demonstrated statistically significant improvement (P < 0.05). One patient underwent revision surgery. Conclusions Hip arthroscopy has good clinical outcomes in the treatment of OO of the acetabulum. Further study on the mechanism of secondary femoroacetabular impingement (FAI) caused by OO of the acetabulum is needed. More cases of arthroscopic excision and longer follow-up are also needed to better prove the clinical outcomes of hip arthroscopy for OO of the acetabulum.

scholarly journals Hip Arthroscopy has Good Clinical Outcomes in the Treatment of Osteoid Osteoma of the Acetabulum

2021 ◽  
Author(s):  
Guanying Gao ◽  
Ruiqi Wu ◽  
Rongge Liu ◽  
Yingfang Ao ◽  
Jianquan Wang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Osteoid Osteoma ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Ct Images ◽  
Harris Hip Score ◽  
Center Edge ◽  
Patient Reported ◽  
Outcome Tool

Abstract Background: Osteoid osteoma (OO) of the acetabulum is a relatively rare disease. The clinical outcomes of hip arthroscopy for treatment of OO of the acetabulum is still uncertain.Methods: We evaluated consecutive patients who were diagnosed with OO of the acetabulum and underwent hip arthroscopy for treatment in our hospital between January 2013 and March 2020. All patients underwent preoperative physical examination. Preoperative supine anteroposterior hip radiographs, cross-table lateral radiographs, CT images, and MR images were obtained for all patients. Alpha angle and lateral center-edge angle were measured before surgery. Supine anteroposterior hip radiographs and CT images were obtained for all patients postoperatively. Preoperative patient-reported outcomes (PROs), including visual analog scale (VAS), the International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS), and PROs at final follow-up were evaluated.Results: A total of 6 patients (mean age, 18.7 years; age range, 6-31 years; 5 males and 1 females) were included in this study. The average follow-up period after surgery was 28.3 months (range, 6–90 months). Before surgery, mean mHHS was 45.2±10.5 (range, 33-56), mean iHOT-12 was 33.3±14.5 (range, 13-49), and mean VAS was 8.2±1.0 (range, 7-9). At one month after surgery, mean mHHS was 78.7±1.9 (range, 77-81), iHOT-12 was 71.0±4.5 (range, 68-80), and mean VAS was 0. At the final post-operative follow-up, mean mHHS was 89.2±2.1 (range, 86-91), iHOT-12 was 93.5±5.0 (range, 88-98), and mean VAS was 0. All results, except VAS between one month after surgery and at final follow-up, demonstrated statistically significant improvement (P < 0.05). One patient underwent revision surgery.Conclusion: Hip arthroscopy has good clinical outcomes in the treatment of OO of the acetabulum.

scholarly journals Treatment of cam-type femoroacetabular impingement

Joints ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 67-71 ◽  
Author(s):  
Gennaro Fiorentino ◽  
Alberto Fontanarosa ◽  
Riccardo Cepparulo ◽  
Alberto Guardoli ◽  
Luca Berni ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Alpha Angle ◽  
Case Series ◽  
Arthroscopic Treatment ◽  
Correct Selection ◽  
Harris Hip Score ◽  
Radiographic Examination ◽  
Level Of Evidence

Purpose: the aim of this study was to evaluate preliminary clinical and radiographic results of arthroscopic treatment of cam-type femoroacetabular impingement (FAI). Methods: thirty-eight patients underwent hip arthroscopy for cam-type FAI between 2009 and 2012. Preoperative assessment was based on clinical examination, modified Harris Hip Score (mHHS) and radiographic examination with anteroposterior pelvis, frogleg and Lequesne views. The patients’ clinical conditions at follow-up were assessed using the mHHS administered as a telephone survey. Radiographic outcome measurements evaluated pre and postoperatively were the alpha angle and femoral head-neck offset. Results: the patients were clinically evaluated at a mean follow-up of 36 months. Radiographic follow-up was performed at an average of 12.7 months. Thirty of the 38 patients (79%) were satisfied with the results of the arthroscopic procedure. A total of nine patients subsequently underwent a total hip replacement. All 30 patients who declared themselves satisfied recorded an mHHS increase; in particular, the mHHS increased from a mean of 52.9 preoperatively (range: 27.5-82.5) to a mean of 85.6 postoperatively (range: 45.1-100.1). Three significant differences between the two groups of patients (satisfied and not satisfied) were recorded: mean age, alpha angle and BMI were all significantly greater in the patients who were not satisfied with the treatment. Conclusions: a crucial aspect in order to obtain good clinical outcomes of arthroscopic treatment of camtype impingement is correct selection of patients who are likely to benefit from this kind of surgery. Hip arthroscopy should be avoided in patients aged over 50 years with risk factors for early osteoarthritis (high BMI and a significantly increased alpha angle). Level of evidence: Level IV, therapeutic case series.

Clinical and Radiographic Presentation of Capsular Iatrogenic Hip Instability After Previous Hip Arthroscopy

2020 ◽  
Vol 48 (12) ◽  
pp. 2927-2932
Author(s):  
Dillon C. O’Neill ◽  
Alexander J. Mortensen ◽  
Peter C. Cannamela ◽  
Stephen K. Aoki
Keyword(s):  
Hip Arthroscopy ◽  
Daily Living ◽  
Patient Reported Outcomes ◽  
Harris Hip Score ◽  
Hip Instability ◽  
Computer Adaptive Test ◽  
Adaptive Test ◽  
Patient Reported ◽  
Modified Harris Hip Score

Background: The clinical and radiographic features of iatrogenic hip instability following hip arthroscopy have been described. However, the prevalence of presenting symptoms and associated imaging findings in patients with hip instability has not been reported. Purpose: To detail the prevalence of clinical and magnetic resonance arthrogram (MRA) findings in a cohort of patients with isolated hip instability and to determine midterm patient-reported outcomes in this patient population. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively reviewed patients from 2014 to 2016 who underwent an isolated capsular repair in the revision hip arthroscopy setting. Patients were excluded if they underwent any concomitant procedures, such as labral repair, reconstruction, femoral osteoplasty, or any other related procedure. Several clinical data points were reviewed, including painful activities, mechanical symptoms, subjective instability, Beighton scores, axial distraction testing (pain, toggle, and apprehension), and distractibility under anesthesia. Patient-reported outcomes—including modified Harris Hip Score, Hip Outcome Score–Sports Subscale, Patient-Reported Outcome Measurement Information System (PROMIS) Physical Function Computer Adaptive Test, and a return patient hip questionnaire—were collected pre- and postoperatively. Pre-revision radiographs were obtained, and lateral center-edge angle and alpha angle were measured on anteroposterior and frog-leg lateral views, respectively. Pre-revision MRAs were reviewed and evaluated for capsular changes. Capsular changes were defined as follows: 0, normal; 1, capsular redundancy; 2, focal capsular rent; and 3, gross extravasation of fluid from the capsule. Results: A total of 31 patients met inclusion criteria (5 male, 26 female; 14 right and 17 left hips). The mean age of patients was 36 years (range, 20-58 years). Overall, 27 (87%) reported hip pain with activities of daily living, and 31 (100%) experienced pain with sports or exercise. In addition, 24 (77%) had at least 1 positive finding on axial distraction testing. All patients had evidence of capsular changes on review of pre-revision MRAs. Out of 31 patients, 23 (74%) were available for follow-up at a minimum of 3.3 years and a mean ± SD of 4.6 ± 0.8 years. On average, modified Harris Hip Score improved by 20.3, Hip Outcome Score–Sports Subscale by 25.1, and PROMIS Physical Function Computer Adaptive Test by 6.4. Additionally, 20 (87%) patients reported improved or much improved physical ability, and 18 (78%) reported improved or much improved pain. Conclusion: The current study suggests that patients with hip instability demonstrate high rates of pain with activities of daily living and exercise, positive findings on axial distraction testing, and evidence of capsular changes on magnetic resonance imaging. Furthermore, these patients improve with revision surgery for capsular repair at midterm follow-up.

scholarly journals Return to Sport Rates and Functional Outcomes Following Bilateral Hip Arthroscopy in High-Level Athletes

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0043
Author(s):  
Benjamin Domb ◽  
Cynthia Kyin ◽  
Jacob Shapira ◽  
David Maldonado ◽  
Ajay Lall ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Return To Sport ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Professional Athlete ◽  
Patient Reported ◽  
High Level ◽  
Modified Harris Hip Score

Objectives: To determine the rate of return to sport (RTS) in high-level athletes undergoing bilateral hip arthroscopy and report minimum 1-year patient-reported outcomes (PROs) for this cohort. We hypothesized that RTS rates, as well as sport-specific PROs, will be lower than the rates and scores previously reported in the literature for unilateral hip arthroscopy. Methods: Data were prospectively collected on all patients undergoing hip arthroscopy at our institution from November 2011 to July 2018. Patients were included if they underwent bilateral hip arthroscopy and were either a high school, collegiate, or professional athlete prior to their first surgery. RTS was defined as a patient’s return to competitive participation in their respective sport. Additional PROs, including modified Harris Hip Score (mHHS), nonarthritic hip score (NAHS), and Hip Outcome Score-Sports Specific Subscale (HOS-SSS), as well as complication rates and future surgeries were documented and compared for all patients. Results: A total of 87 patients met inclusion criteria, for which follow-up was available for 82 (94.3%). At latest follow-up, 44 (53.7%) patients returned to sport. Of patients returning, 56% did so at the same level or higher. The most common reasons for not returning to sport were due to graduation/lifestyle change (47.4%) and hip symptoms (44.7%). Patients returning to sport had significantly higher PROs at latest follow-up relative to those who did not return, including for mHHS (93.7 vs. 87.5), NAHS (94.4 vs. 88.2), HOS-SSS (90.9 vs. 78.2) (P < 0.05). Rates of achieving PASS and MCID for mHHS were not significantly different. However, for HOS-SSS, patients who returned had significantly higher rates of achieving the MCID and PASS. Conclusion: Rates of RTS after bilateral hip arthroscopy are lower than those after unilateral hip arthroscopy. When comparing patients that returned to sports and those who did not return, we show that although both groups show a significant improvement in PROs following surgery, those that returned to sport achieved significantly higher scores in all outcome measures. In addition, patients returning to sports showed a significantly higher rate of attaining MCID and PASS scores for the HOS-SSS, possibly attesting to the validity of this score and its thresholds.

scholarly journals Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

2019 ◽  
Author(s):  
David R. Maldonado ◽  
Mitchell J. Yelton ◽  
Philip J. Rosinsky ◽  
Jacob Shapira ◽  
Mitchell Meghpara ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Arthroscopic Surgery ◽  
Return To Sport ◽  
Return To Play ◽  
Harris Hip Score ◽  
Tennis Players ◽  
Labral Tears ◽  
Patient Reported ◽  
Modified Harris Hip Score

Abstract 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 play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic 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 (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level 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. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. 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% return to sport 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. Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved.

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