Sex-Based Differences in Hip Arthroscopic Findings, Management, and Outcomes: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Hip arthroscopy effectively treats femoroacetabular impingement (FAI) and labral tears, improving patient-reported outcomes (PROs).
• Uncertainty exists regarding whether sex-based differences in anatomy and management influence hip arthroscopy outcomes.

Purpose of the Study:

• To systematically review sex-based differences in radiographic findings, intraoperative pathology, surgical management, and postoperative outcomes following hip arthroscopy.

Main Methods:

• Systematic literature review adhering to PRISMA guidelines, searching PubMed, CENTRAL, and Scopus.
• Inclusion of studies reporting sex-specific PROs with a minimum 2-year follow-up for hip arthroscopy in FAI or labral pathology.
• Evaluation of methodological quality using the Methodological Index for Non-Randomized Studies.

Main Results:

• Six studies (3914 hips) showed significant postoperative PRO improvements in all patients (p < .05).
• Male patients exhibited larger alpha angles and more advanced chondral damage; females underwent more capsular repairs.
• No significant sex-based differences were found in PROs, clinically important difference achievement, revision rates, or conversion to total hip arthroplasty.

Conclusions:

• Male and female patients achieve comparable improvements in PROs, clinical thresholds, and revision rates after hip arthroscopy.
• Observed sex-based differences in radiographic findings and intraoperative pathology do not lead to clinically significant outcome disparities.