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Return to Basketball After Primary Hip Arthroscopy for Femoroacetabular Impingement: Minimum 5-Year Follow-up
Angela M Mercurio1, Sanathan Iyer1, John-Rudolph Smith1
1Division of Sports Medicine, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Background:
Femoroacetabular impingement (FAI) is a common injury experienced by basketball players. Surgical management with arthroscopic labral repair and femoral osteochondroplasty can lead to successful outcomes for athletes whose nonoperative management fails. Recent studies have demonstrated that athletes undergoing hip arthroscopy in the setting of FAI had favorable return-to-sport (RTS) and sport continuation outcomes.
Purpose:
To evaluate patient-reported outcome measures (PROMs) and RTS rates at minimum 5-year follow-up in basketball players after hip arthroscopy for FAI.
Study Design:
Case series; Level of evidence, 4.
Methods:
All active basketball players at the recreational, high school, and collegiate levels who underwent primary hip arthroscopy with labral repair for FAI between August 2009 and December 2019 were identified. Postoperative RTS, revision rates, and surgery satisfaction at final follow-up were evaluated. PROMs were also analyzed as follows: visual analog scale, Tegner Activity Scale, modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, and Hip Outcome Score-Sport.
Results:
Fifty-three patients (64 hips) were included with a mean ± SD age of 21.2 ± 6.0 years. Most athletes played recreational or high school basketball (85%), while 15% played college basketball. Forty-three patients attempted to return to basketball. Of these patients, 35 (81%) returned to basketball after surgery, with 32 (91%) returning to the same level of play. Patients who returned to basketball had significantly improved outcomes on the modified Harris Hip Score (P = .006), Hip Outcome Score-Activities of Daily Living (P = .007), Hip Outcome Score-Sport (P = .004), Tegner Activity Scale (P = .010), and visual analog scale with use (P = .041) as compared with those who did not return. High school athletes had decreased odds of RTS when compared with recreational athletes (P = .01). There was significant improvement in all PROMs from baseline to minimum 5-year follow-up (P < .05).
Conclusion:
At minimum 5-year follow-up, basketball players demonstrated durable improvements in PROMs and an RTS rate of 81% after hip arthroscopy for FAI. The majority of athletes returned to the same level of competition. There were significantly improved PROMs in patients who returned to sport versus those who did not. High school athletes had decreased odds of RTS when compared with recreational athletes. However, body mass index, sex, age, alpha angle, and basketball position did not significantly correlate with RTS outcomes.
