Pathologic Findings on Hip Arthroscopy in High-Level Athletes Competing in Flexibility Sports
Authors: Saks BR, Monahan PF, Maldonado DR, Jimenez AE, Ankem HK, Sabetian PW, Lall AC, Domb BG
Journal: American Journal of Sports Medicine, March 2022
DOI: 10.1177/03635465221077002
Background
High-level athletes in flexibility sports (FS) such as gymnastics, dance, and martial arts place increased stress on their hips due to extreme range of motion. This study characterizes the arthroscopic findings and surgical outcomes in FS athletes compared to those in non-flexibility sports (NFS).
Methods
- Comparative analysis of arthroscopic findings and 2-year patient-reported outcomes in FS vs NFS athletes with FAIS and labral pathology.
- Included variables: femoral head cartilage lesions, ligamentum teres (LT) tears, and return-to-sport rates.
Key Findings
- FS athletes had higher rates of femoral head cartilage lesions (12%) and LT tears (48%) compared to NFS athletes (2% and 26%, respectively).
- Despite more extensive pathology, FS athletes had similar improvements in PROs post-surgery.
- 75.6% of FS athletes returned to sport, statistically comparable to NFS athletes.
Conclusions
Even with more advanced intra-articular damage, FS athletes achieve meaningful clinical improvement and RTS after hip arthroscopy.
What Does This Mean for Providers?
Flexibility athletes with FAIS often present with greater intra-articular degeneration, especially involving the LT and cartilage. Despite this, hip arthroscopy remains effective in restoring function and enabling return to sport. Preoperative counseling should acknowledge this pattern of pathology while reinforcing the potential for positive outcomes.