Midterm Outcomes of Primary Hip Arthroscopy in Athletes Older Than Age 40: A Propensity-Matched Controlled Study
Author(s):Schab AR, McCarroll TR, Walsh EG, Kahana-Rojkind AH, Quesada-Jimenez R, Domb BG.
DOI Link: 10.1177/03635465251407118
Background
Outcomes of hip arthroscopy in “master athletes” (patients ≥40 years who remain active in sport) are not well defined, particularly at midterm follow-up compared with nonathletic populations.
Methods
This Level 3 cohort study evaluated patients undergoing primary hip arthroscopy between 2008 and 2019 with minimum 5-year follow-up. Master athletes (MAs) were defined as patients ≥40 years participating in sports within 1 year preoperatively. MAs were propensity-matched 1:1 to nonathlete (NA) controls based on age, sex, BMI, and acetabular cartilage status. Outcomes included patient-reported outcomes (mHHS, NAHS, HOS-SSS), clinically relevant threshold achievement (MCID, PASS, MOI), and secondary procedures including arthroplasty-free survivorship.
Key Findings
MAs demonstrated higher preoperative and postoperative PRO scores compared with NAs (P < .05).
Magnitude of improvement was comparable between groups.
MAs achieved clinically meaningful thresholds (MCID, PASS, MOI) at higher rates across multiple measures.
Arthroplasty-free survivorship was significantly higher in MAs (94.9% vs 71.2%; P < .01).
Secondary arthroscopy rates were low and similar between groups (1.6% vs 5.1%; P > .05).
Conclusion
Master athletes undergoing hip arthroscopy demonstrate durable midterm outcomes with comparable improvements to nonathletes, higher rates of clinically meaningful benefit, and superior arthroplasty-free survivorship at 5 years.
What Does This Mean for Providers?
Age ≥40 years and continued athletic participation should not be considered a limiting factor for hip arthroscopy outcomes. Master athletes demonstrate strong survivorship and high rates of clinical benefit achievement, with similar relative improvements compared to younger or less active populations. These findings support maintaining surgical candidacy in appropriately selected older athletic patients.