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 Clinical Outcomes of Revision Hip Arthroscopy for Synovial Chondromatosis

2021 ◽  
Author(s):  
Guanying Gao ◽  
Hongjie Huang ◽  
Jianquan Wang ◽  
Yingfang Ao ◽  
Yan Xu
Keyword(s):  
Clinical Outcomes ◽  
Revision Surgery ◽  
Hip Arthroscopy ◽  
Synovial Chondromatosis ◽  
Harris Hip Score ◽  
Radiographic Evaluation ◽  
Patient Reported ◽  
Before And After ◽  
Outcome Tool

Abstract Background: Synovial chondromatosis (SC) is a relatively rare disease and there were few studies on causes and clinical outcomes of revision surgery for SC. The purpose of this study was to evaluate clinical outcomes of revision hip arthroscopy for synovial chondromatosis.Methods: We evaluated consecutive patients who underwent revision hip arthroscopy for SC in our hospital between January 2008 and January 2020. Radiographic evaluation was made before and after surgery. Preoperative patient-reported outcomes (PROs) and PROs at final follow-up were obtained, including visual analog scale (VAS) for pain, the International Hip Outcome Tool-12 (iHOT-12) and modified Harris Hip Score (mHHS).Results: A total of 8 patients (mean age, 39.5 years; age range, 27-62 years; 5 males and 3 females) were included in this study. The recurrence rate of hip SC in our hospital was 6.8%. The average follow-up period after surgery was 47.3 months (range, 12–120 months). Before surgery, mean mHHS was 60.6±17.3 (range, 20-77), mean iHOT-12 was 43.8±13.7 (range, 18-69), and mean VAS was 3.1±1.7 (range, 1-7). At the final post-operative follow-up, mean mHHS was 83.8±16.6 (range, 43-91), iHOT-12 was 80.6±19.7 (range, 32-90), and mean VAS was 0.6±1.8 (range, 0-5). All results demonstrated statistically significant improvement (P < 0.05). Recurrence of SC was found in 2 patients 1 year and 4 years after revision hip arthroscopy, respectively.Conclusion: Hip arthroscopy had good clinical outcomes for revision surgery of SC.

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.

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 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 Full-Thickness Gluteus Medius Tears With or Without Concomitant Hip Arthroscopy: Minimum 2-Year Outcomes Using an Open Approach and Contemporary Tendon Repair Techniques

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712092933 ◽  
Author(s):  
David R. Maldonado ◽  
Shawn Annin ◽  
Jeffery W. Chen ◽  
Philip J. Rosinsky ◽  
Jacob Shapira ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Open Repair ◽  
Tendon Repair ◽  
Gluteus Medius ◽  
Harris Hip Score ◽  
Open Approach ◽  
Full Thickness ◽  
Patient Reported ◽  
Repair Techniques

Background: Gluteus medius (GM) tears are a well-established source of pain and disability. An open approach has been recognized with complete full-thickness and large GM tears, yet the current literature provides few reports on outcomes for this specific situation. Purpose: To report and analyze minimum 2-year patient-reported outcomes (PROs) from patients who underwent open GM repair in the setting of a full-thickness tear with or without concomitant hip arthroscopy through use of contemporary tendon repair techniques. Study Design: Case series; Level of evidence, 4. Methods: Prospectively collected data were retrospectively reviewed for patients who underwent hip preservation surgery and total hip arthroplasty (THA) between April 2008 and May 2017. Patients were included in this study if they underwent open repair of GM full-thickness tears. The exclusion criteria were incomplete follow-up, workers’ compensation status, repair regarding size and pattern of the GM, open repair of partial GM tear, open repair with allograft or autograft augmentation, and/or additional gluteus maximus transfer. Pre- and postoperative PROs for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), and visual analog scale (VAS) score for pain and satisfaction were recorded. Statistical significance was set at P < .05. Results: A total of 36 patients were included, of whom 12 received concomitant hip arthroscopy for intra-articular procedures. The mean ± SD age, body mass index, and follow-up time were 65.18 ± 12.69 years, 28.97 ± 4.95 kg/m2, and 40.8 ± 26.19 months, respectively. At minimum 2-year follow-up, the following outcome measures improved significantly: mHHS (from 54.72 ± 15.89 to 73.12 ± 19.47; P < .0001), NAHS (from 56.05 ± 12.47 to 75.22 ± 19.15; P < .0001); HOS-SSS (from 20.30 ± 20.21 to 44.23 ± 35.85; P < .0001), and VAS (from 4.95 ± 2.70 to 2.67 ± 2.81; P < .0001). There was 1 (2.8%) conversion to THA at 48 months after the index procedure. Conclusion: Patients who underwent open repairs in the setting of full-thickness GM tears via contemporary tendon repair techniques, with or without concomitant hip arthroscopy, achieved favorable results in several PRO scores at minimum 2-year follow-up.

Arthroscopic Labral Treatment in Adolescents: Clinical Outcomes With Minimum 5-Year Follow-up

2019 ◽  
Vol 47 (4) ◽  
pp. 870-875 ◽  
Author(s):  
Jody M. Litrenta ◽  
Brian H. Mu ◽  
Austin W. Chen ◽  
Itay Perets ◽  
Victor Ortiz-Declet ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Outcome Measures ◽  
Hip Arthroscopy ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Labral Repair ◽  
Harris Hip Score ◽  
Labral Tears ◽  
Patient Reported

Background: The success of hip arthroscopy has led to increased application in younger populations. However, hip arthroscopy remains a challenging procedure, and its safety and efficacy in the adolescent population have been controversial. Most existing literature on outcomes in such patients contains only short-term follow-up, and a paucity of evidence is available regarding long-term outcomes in adolescents. Purpose: To report on clinical outcomes at a minimum 5-year follow-up in patients younger than 18 years who underwent arthroscopic treatment of labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively reviewed on all patients younger than 18 years who underwent hip arthroscopy in a tertiary hip preservation setting at a single institution. Patients were excluded if they had previous ipsilateral hip conditions or surgery. All patients underwent either labral repair or debridement for treatment of a labral tear. Patient-reported outcome measures were recorded at 3 months and at 1, 2, or a minimum of 5 years. These included the modified Harris Hip Score (mHHS), Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale (HOS-SSS), visual analog scale, and patient satisfaction. Additionally, the abbreviated International Hip Outcome Tool and Short Form Health Survey were collected at latest follow-up. Results: The study included 44 hips in 32 patients that underwent arthroscopic labral repair (86.4%) or labral debridement (13.6%) between April 2008 and April 2011, with latest follow-up at a mean of 69.2 months (range, 60.0-89.9 months) postoperatively. The average age at surgery was 16.3 years (range, 14.2-17.9 years), and 39 hips from female patients. Statistically significant improvements were seen in all patient-reported outcome measures from preoperative to minimum 5-year follow-up. Improvements were noted at 1-year follow-up and maintained at minimum 5-year follow-up. At the latest follow-up, the Patient Acceptable Symptomatic State was achieved in 95.5% of patients for the mHHS and 72.7% for the HOS-SSS. Two patients subsequently underwent secondary arthroscopy on the ipsilateral hip; however, the survivorship of all hips was 100%. Conclusion: Hip arthroscopy for the treatment of labral tears in adolescents remains a technically challenging procedure that should be approached with appropriate caution. The results of the present study on a population treated in a specialized hip preservation center demonstrate that hip arthroscopy is a safe procedure with stable improvement in patient-reported outcome measures at 5 years.

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.

Arthroscopic Repair of the Hip Abductor Musculotendinous Unit: The Effect of Microfracture on Clinical Outcomes

2021 ◽  
pp. 036354652199967
Author(s):  
Baris Kocaoglu ◽  
Ahmet Emre Paksoy ◽  
Simone Cerciello ◽  
Matthieu Ollivier ◽  
Romain Seil ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Surgical Repair ◽  
Gluteus Medius ◽  
Arthroscopic Repair ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Outcome Score ◽  
Significant Difference ◽  
Hip Abductor ◽  
Tendon Tears

Background: Endoscopic surgical repair has become a common procedure for treating patients with hip abductor tendon tears. Considering that retear rates are high after the repair of gluteus medius and minimus tendons, exploring alternative strategies to enhance structural healing is important. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of adding microfracture to single-row repair (SR) on outcomes after the surgical repair of gluteus medius and minimus tendons and compare with SR and double-row repair (DR) without microfracture. We hypothesized that microfracture of the trochanteric footprint with SR would lead to superior clinical outcomes and lower clinically evident retear rates compared with SR and DR without the addition of microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 50 patients who underwent primary arthroscopic repair of hip gluteus medius and minimus tendon tears were investigated. Patients were divided into 3 groups: DR, 16 patients; SR, 14 patients; and SR with microfracture (SRM), 20 patients. Patients were evaluated with a visual analog scale (VAS) for pain as well as the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport Specific (HOS-SS), and modified Harris Hip Score (mHHS) both preoperatively and at a minimum 2-year follow-up (mean, 30 months). Results: Among the SR, SRM, and DR groups, the greatest decrease in VAS scores and increase in mHHS, HOS-ADL, and HOS-SS scores were seen in the SRM group, and all the differences were significant ( P < .001 to P = .006). The abductor tendon retear rates were 31.3%, 35.7%, and 15.0% in the DR, SR, and SRM groups, respectively. Retear rates were lower in the SRM group compared with the SR and DR groups ( P = .042); however, there was no significant difference between the SR and DR groups ( P = .32) in terms of retear rates. Conclusion: Endoscopic SR with microfracture was a safe, practical, and effective technique and had the potential advantage of enhancing biological healing at the footprint. The addition of microfracturing the trochanteric footprint significantly lowered the retear rate and provided better functional outcomes than SR and DR without microfracture.

Comparing Midterm Outcomes of High-Level Athletes Versus Nonathletes Undergoing Primary Hip Arthroscopy: A Propensity-Matched Comparison With Minimum 5-Year Follow-up

2021 ◽  
pp. 036354652110417
Author(s):  
Andrew E. Jimenez ◽  
Peter F. Monahan ◽  
David R. Maldonado ◽  
Benjamin R. Saks ◽  
Hari K. Ankem ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Statistical Significance ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Control Group ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
High Level

Background: High-level athletes (HLAs) have been shown to have better short-term outcomes than nonathletes (NAs) after hip arthroscopy. Purpose: (1) To report midterm outcomes of HLAs after primary hip arthroscopy and (2) to compare their results with a propensity-matched cohort of NA patients. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed between February 2008 and November 2015 for HLAs (professional, college, or high school) who underwent primary hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS). HLAs were included if they had preoperative, minimum 2-year, and minimum 5-year follow-up data for the modified 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 outcomes (PROs), patient acceptable symptomatic state (PASS), minimal clinically important difference (MCID), and return to sport were reported. The HLA study group was propensity-matched to a control group of NA patients for comparison. Results: A total 65 HLA patients (67 hips) were included in the final analysis with mean follow-up time of 74.6 ± 16.7 months. HLAs 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 with the propensity-matched NA control group, HLAs 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 the HLA patients achieved PASS for HOS-SSS at higher rates that trended toward statistical significance (66.1% vs 48.4%; P = .07). NA patients underwent revision arthroscopic surgery at similar rates as HLA patients (14.9% vs 9.0%, respectively; P = .424). Conclusion: Primary hip arthroscopy results in favorable midterm outcomes in HLAs. When compared with a propensity-matched NA control group, HLAs demonstrated a tendency toward higher rates of achieving PASS for HOS-SSS but similar arthroscopic revision rates at minimum 5-year follow-up.

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

2020 ◽  
Author(s):  
David R. Maldonado ◽  
Mitchell J. Yelton ◽  
Philip J. Rosinsky ◽  
Jacob Shapira ◽  
Mitchell Meghpara ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Cartilage Damage ◽  
Arthroscopic Surgery ◽  
Return To Sport ◽  
Return To Play ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Tennis Players ◽  
Patient Reported

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 by players with a continued interest in playing. The severity of cartilage damage was shown to not influence rate of returned to sport nor PROs in this population. The data here may be useful in counseling tennis players of various levels who are considering arthroscopic treatment of a hip injury. Level of Evidence: IV

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