Postoperative Alpha Angle Is Predictive of Return to Sport in Athletes Undergoing Hip Arthroscopy for Femoroacetabular Impingement
Authors: Monahan PF, Jimenez AE, Owens JS, Lee MS, Maldonado DR, Saks BR, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2021.09.015
Background
Return to sport (RTS) is a critical outcome for athletes treated for FAI. This study investigates whether the postoperative alpha angle can predict successful RTS following hip arthroscopy.
Methods
A cohort of 136 competitive athletes who underwent hip arthroscopy for FAI was reviewed. Postoperative radiographic alpha angles, competition level, and PROs were analyzed to determine associations with RTS.
Key Findings
- Athletes with a postoperative alpha angle ≤46° were significantly more likely to return to sport.
- The alpha angle was an independent predictor of RTS success, even after accounting for other clinical factors.
Conclusions
Achieving a postoperative alpha angle of ≤46° is strongly associated with higher RTS rates in athletes following arthroscopy for FAI.
What Does This Mean for Providers?
- Meticulous femoral osteoplasty aimed at achieving a postoperative alpha angle ≤46° should be prioritized in athletic patients undergoing arthroscopy for FAI.
- Postoperative alpha angle can be used as a prognostic tool for RTS counseling and may serve as a quality metric for surgical adequacy.
- Consider routine postoperative imaging to evaluate alpha angle reduction, particularly in patients with high RTS expectations.