Return to Sports and Minimum 2-Year Outcomes of Hip Arthroscopy in Elite Athletes With and Without Coexisting Low Back Pain: A Propensity-Matched Comparison
Authors: Jimenez AE, Owens JS, Monahan PF, Maldonado DR, Saks BR, Sabetian PW, Ankem HK, Lall AC, Domb BG
DOI: 10.1177/03635465211056964
Background
Low back pain (LBP) is common in elite athletes with femoroacetabular impingement syndrome (FAIS) and may complicate hip pathology and treatment outcomes. This study evaluates whether coexisting LBP influences outcomes after hip arthroscopy.
Methods
Elite athletes with and without LBP undergoing hip arthroscopy for FAIS were compared using propensity matching. Patient-reported outcomes (PROs), return-to-sport (RTS) rates, and postoperative LBP status were analyzed over a minimum 2-year follow-up.
Key Findings
- Athletes with LBP had significant postoperative improvements in PROs comparable to those without LBP.
- RTS rates were similar between groups (approximately 75.8%).
- Most athletes with preoperative LBP (79%) reported resolution of back pain after surgery.
Conclusions
Hip arthroscopy yields favorable outcomes in elite athletes regardless of preexisting LBP, and addressing hip pathology may contribute to improvement or resolution of associated back symptoms.
What Does This Mean for Providers?
- Do not consider coexisting LBP a contraindication or negative prognostic factor for hip arthroscopy in elite athletes.
- Assess and monitor back symptoms pre- and postoperatively, as hip surgery may alleviate secondary LBP.
- Counsel athletes with LBP that their likelihood of return to sport and symptomatic improvement is comparable to those without LBP.