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Return to Sport in Australian Football League Footballers After Hip Arthroscopy and Midterm Outcome

      Purpose

      To study the return to sport in a series of professional athletes in a single sport (Australian Rules Football), operated on arthroscopically for hip joint pathology.

      Methods

      We performed a retrospective review of the senior author's surgical database starting in 2003. All of the patients who were Australian Football League (AFL) professional players with a minimum of 2 years' follow-up were included. Intra-articular pathologies were identified and treated. All patients were prospectively assessed with the modified Harris Hip Score (MHHS) and the Non-Arthritic Hip Score (NAHS). In addition, information about the active participation of the patients in their teams and return to professional sport was obtained from AFL registers and team physicians.

      Results

      Since 2003, the senior author has operated on 36 male professional AFL players; 26 of 27 with at least 2 years' follow-up were available for review. The mean age at the time of surgery was 22.1 years (range, 16 to 30 years), and 8 patients had bilateral pathology; therefore 34 hips were operated on. This report refers to those 26 players and 34 hips. All but 1 of the patients returned to play professionally. By the last survey (October 2011), 16 patients (62%) were still playing professional AFL football, and they have been playing for a mean of 52.5 months after surgery. Ten patients had retired from professional football, but they had all returned to play professionally after surgery. Only one of them retired for causes related to hip disability. There was a significant improvement in preoperative outcome scores. The MHHS and NAHS improved from 83.6 to 98 and from 85.3 to 97.1, respectively, in the players who were still playing (P < .05). Rim lesions were present in 33 hips (97%). Femoral osteochondroplasty was performed in 26 hips (76%).

      Conclusions

      Arthroscopic treatment of intra-articular pathologies in professional athletes resulted in a 96% rate of return to elite-level sport and a durable increase in the MHHS and NAHS.

      Level of Evidence

      Level IV, therapeutic case series.
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      References

        • Singh P.J.
        • O'Donnell J.M.
        The outcome of hip arthroscopy in Australian football league players: A review of 27 hips.
        Arthroscopy. 2010; 26: 743-749
        • Philippon M.J.
        • Weiss D.R.
        • Kuppersmith D.A.
        • Briggs K.K.
        • Hay C.J.
        Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players.
        Am J Sports Med. 2010; 38: 99-104
        • Byrd J.W.T.
        • Jones K.S.
        Arthroscopic management of femoroacetabular impingement in athletes.
        Am J Sports Med. 2011; 39: 7S-13S
        • Walden M.
        • Hagglund M.
        • Ekstrand J.
        UEFA Champions League study: A prospective study of injuries in professional football during the 2001-2002 season.
        Br J Sports Med. 2005; 39: 542-546
        • Ganz R.
        • Parvizi J.
        • Beck M.
        • Leunig M.
        • Nötzli H.
        • Siebenrock K.A.
        Femoroacetabular impingement: A cause for osteoarthritis of the hip.
        Clin Orthop Relat Res. 2003; : 112-120
        • Crawford J.R.
        • Villar R.N.
        Current concept in the management of femoroacetabular impingement.
        J Bone Joint Surg Br. 2005; 87: 1459-1462
        • Bedi A.
        • Dolan M.
        • Leunig M.
        • Kelly B.T.
        Static and dynamic mechanical causes of hip pain.
        Arthroscopy. 2011; 27: 235-251
        • Burnett R.S.
        • Della Rocca G.J.
        • Prather H.
        • Curry M.
        • Maloney W.J.
        • Clohisy J.C.
        Clinical presentation of patients with tears of the acetabular labrum.
        J Bone Joint Surg Am. 2006; 88: 1448-1457
        • Weir A.
        • de Vos R.J.
        • Moen M.
        • Holmich P.
        • Tol J.L.
        Prevalence of radiological signs of femoroacetabular impingement in patients presenting with long-standing adductor-related groin pain.
        Br J Sports Med. 2011; 45: 6-9
        • Verrall G.M.
        • Slavotinek J.P.
        • Barnes P.G.
        • et al.
        Hip joint range of motion restriction precedes athletic chronic groin injury.
        J Sci Med Sport. 2007; 10: 463-466
        • Feeley B.T.
        • Powell J.W.
        • Muller M.S.
        • Barnes R.P.
        • Warren R.F.
        • Kelly B.T.
        Hip injuries and labral tears in the national football league.
        Am J Sports Med. 2008; 36: 2187-2195
      1. Orchard J, Seward H. 2010 Injury Report Australian Football League. May 4, 2011. Available from: https://secure.ausport.gov.au/__data/assets/pdf_file/0006/458979/AFLinjuryreport2010.pdf. Accessed July 2012.

        • Orchard J.
        • Hoskins W.
        For debate: Consensus injury definitions in team sports should focus on missed playing time.
        Clin J Sport Med. 2007; 17: 192-196
        • Mason J.B.
        • McCarthy J.C.
        • O'Donnell J.
        • et al.
        Hip arthroscopy: Surgical approach, positioning, and distraction.
        Clin Orthop Relat Res. 2003; : 29-37
        • Lage L.A.
        • Patel J.V.
        • Villar R.N.
        The acetabular labral tear: An arthroscopic classification.
        Arthroscopy. 1996; 12: 269-272
        • Gray A.J.
        • Villar R.N.
        The ligamentum teres of the hip: An arthroscopic classification of its pathology.
        Arthroscopy. 1997; 1: 1-4
        • Bardakos N.V.
        • Villar R.N.
        The ligamentum teres of the adult hip.
        J Bone Joint Surg Br. 2009; 91: 8-15
        • Brismar B.H.
        • Wredark T.
        • Movin T.
        • Leandersson J.
        • Svensson O.
        Observer reliability in the arthroscopic classification of osteoarthritis of the knee.
        J Bone Joint Surg Br. 2002; 84: 42-47
        • Haviv B.
        • Singh P.J.
        • Takla A.
        • O'Donnell J.
        Arthroscopic femoral osteochondroplasty for cam lesions with isolated acetabular chondral damage.
        J Bone Joint Surg Br. 2010; 92: 629-633
        • Crawford K.
        • Philippon M.J.
        • Sekiya J.K.
        • Rodkey W.G.
        • Steadman J.R.
        Microfracture of the hip in athletes.
        Clin Sports Med. 2006; 25: 327-335
        • Haviv B.
        • O'Donnell J.
        Arthroscopic treatment for acetabular labral tears of the hip without bony dysmorphism.
        Am J Sports Med. 2011; 39: 79S-84S
        • Nho S.J.
        • Magennis E.M.
        • Singh C.K.
        • Kelly B.T.
        Outcomes after the arthroscopic treatment of femoroacetabular impingement in a mixed group of high-level athletes.
        Am J Sports Med. 2011; 39: 14S-19S
        • Byrd J.W.T.
        • Jones K.S.
        Hip arthroscopy in athletes: 10-year follow-up.
        Am J Sports Med. 2009; 37: 2140-2143
        • Philippon M.
        • Schenker M.
        • Briggs K.
        • Kuppersmith D.
        Femoroacetabular impingement in 45 professional athletes: Associated pathologies and return to sport following arthroscopic decompression.
        Knee Surg Sports Traumatol Arthrosc. 2007; 15: 908-914