Return to Sport After Hip Arthroscopy With Full-Thickness Acetabular Chondral Defect Treated With Microfracture

Only a few studies have explored return to recreational sport activity after arthroscopic microfracture for full-thickness acetabular lesions.

Recreational athletes undergoing acetabular microfracture, in addition to general hip arthroscopy procedures, would not achieve similar sport activity to recreational athletes undergoing hip arthroscopy without microfracture at the 5-year follow-up.

Cohort study; Level of evidence, 3.

A retrospective review was conducted of a prospectively collected multicenter hip arthroscopy database of patients undergoing acetabular microfracture for full-thickness chondral lesions. Inclusion criteria were patients between 18 and 50 years of age who had participated in recreational sports before surgery, a diagnosis of femoroacetabular impingement, arthroscopic microfracture for full-thickness chondral lesion, labral repair, complete clinical patient-reported outcomes (PROs), radiographic measurements, and at least 5 years of postoperative follow-up. For each patient included in the study, 1 patient without chondral damage was paired at a 1:1 ratio based on age and sex. The following were assessed: radiographic evaluation, primary preoperative sport, Tegner activity scale score, self-administered Hip Outcome Score (HOS) questionnaire with Activities of Daily Living Subscale (ADL) and Sports-Specific Subscale (SSS) scores, and self-administered short version of the 12-item International Hip Outcome Tool (iHOT-12) score. Clinical relevance was measured using the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB).

A total of 33 patients met the inclusion criteria and were matched with 33 patients without chondral damage. There were no patients lost to follow-up. Both groups showed significant improvement from preoperative PROs to 5-year follow-up. There was no difference in the frequency of patients achieving the MCID, PASS, and SCB for PROs. Return to sport at the 5-year follow-up was similar between groups. Sixteen patients (66.7%) in the microfracture group changed the type of sport they participated in, compared with 9 patients (34.6%) in control group; this difference was statistically significant. The Tegner activity scale score decreased significantly in both groups, but there was no difference between them.

Recreational athletes with full-thickness chondral lesions treated with arthroscopy acetabular microfracture experienced similar return to play to recreational athletes without chondral lesions at the 5-year follow-up. However, a statistically significantly higher rate of athletes in the microfracture group changed the type of sport they participated in.