Competitive Athletes Undergoing Hip Arthroscopy with Duration of Symptoms Less Than One Year Demonstrated Superior Postoperative Outcome Scores But Similar Rates of Achieving Psychometric Thresholds Compared to Competitive Athletes Who Underwent Hip Arthroscopy With Symptoms For More Than One Year
Abstract
Purpose: To report minimum 2-year patient-reported outcome scores (PROs) and return to sport (RTS) for competitive athletes undergoing primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) within one year of symptom onset and to compare these results with a propensity-matched control group of competitive athletes with symptoms for over one year.
Methods: Data on professional, collegiate, high-school, and organized amateur athletes who underwent primary hip arthroscopy within one year of symptom onset between April 2008 and November 2017 were collected. RTS and minimum 2-year PROs were collected for the modified Harris Hip Score (mHHS), Non-arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12), and visual analog pain scale (VAS). Rates of achieving minimal clinically important difference (MCID) were also evaluated. These patients were propensity-matched to a control group of competitive athletes with symptoms for over one year for comparison.
Results: Fifty competitive athletes (51 hips, 54.9% female) were included in the study group with a mean follow-up of 70.9 ± 29.1 months and age of 23.6 ± 11.3 years. They demonstrated significant improvement from preoperative to latest follow-up for all recorded PROs (P < 0.001) and RTS at a rate of 72.9%. When outcomes were compared to the control group, the study group demonstrated similar preoperative scores for all PROs but significantly better minimum 2-year postoperative scores for NAHS (93.8 vs 85.1, P = 0.0001), HOS-SSS (89.1 vs 77.2, P = 0.001), iHOT-12 (87.7 vs 76.4, P = 0.011), and VAS (1.5 vs 2.4, P = 0.027). Rates of achieving MCID for HOS-SSS and mHHS were comparable between groups. Further, RTS rates were similar between groups (P = 0.301).
Conclusion: Competitive athletes undergoing primary hip arthroscopy with symptoms for less than one year demonstrated improved 2-year PROs compared to a propensity-matched control group with symptoms for over one year, but the rates achieving MCID and RTS were similar between groups.