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Return to Basketball After Hip Arthroscopy: Minimum 2-Year Follow-up

      Purpose

      To present minimum 2-year patient-reported outcomes (PROs) and return to sport (RTS) data for a population of basketball players after hip arthroscopy.

      Methods

      Data were prospectively collected and retrospectively reviewed for all patients who underwent hip arthroscopy between February 2009 and May 2014. Patients with preoperative and minimum 2-year postoperative PROs, visual analog scale score for pain, and satisfaction, who regularly played basketball within 1 year before surgery, and who attempted to RTS met the inclusion criteria. Exclusion criteria were previous ipsilateral hip surgery or conditions such as fracture, dysplasia, or femoral avascular necrosis. Patients were matched 1:1 to a control group composed of those who did not play any sports before surgery, based on the following matching criteria: age ±5 years, sex, and body mass index ±5. Statistical analysis was performed to determine significant differences in PROs. Conversion to total hip arthroplasty (THA) was considered an endpoint.

      Results

      Thirty-one patients (81.6%) met inclusion criteria with follow-up of 46.8 ± 20.6 months. The mean age was 30.0 ± 12.3, and the mean body mass index was 26.3 ± 6.5. Male patients (64.5%) outnumbered female patients (35.5%). A majority of the players (54.8%) identified themselves as recreational athletes; the remainder competed at the high school, collegiate, amateur, or professional level. There was significant (P < .001) improvement in all PRO measures and visual-analog scale scores from baseline to a minimum 2-year follow-up. At the most recent follow-up, mean patient satisfaction was 8.1 ± 2.1. Twenty-two (78.6%), and 23 patients (82.1%) achieved the patient acceptable symptom state on the modified Harris Hip Score and the Hip Outcomes Score–Sports Specific Subscale. Twenty-one (75.0%) and 17 (60.7%) patients had a minimal clinically important difference on the modified Harris Hip Score and the Hip Outcomes Score–Sports Specific Subscale, respectively. Three patients (9.7%) with an average age of 47.5 (P = .023) converted to THA at a mean of 35.9 ± 7.2 (range 29.66-43.75) months after arthroscopy. At the most recent follow-up, the RTS rate was 83.9%. Subjective ability level was the same or higher in 23 patients (74.2%).

      Conclusion

      Hip arthroscopy in basketball athletes demonstrates a significant increase in PROs, a high RTS rate, and a low risk of complications. Hip arthroscopy may be considered in basketball players <40 years old for whom nonoperative treatment fails and who have a significantly limited level of play. Careful patient selection and counseling should be used when considering hip arthroscopy in basketball players >40 years old because there may be a high rate of conversion to THA.

      Level of Evidence

      Level III, retrospective comparative study.
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      References

        • Griffin D.R.
        • Dickenson E.J.
        • O’Donnell J.
        • et al.
        The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): An international consensus statement.
        Br J Sports Med. 2016; 50: 1169-1176
        • Casartelli N.C.
        • Leunig M.
        • Maffiuletti N.A.
        • Bizzini M.
        Return to sport after hip surgery for femoroacetabular impingement: A systematic review.
        Br J Sports Med. 2015; 49: 819-824
        • Nawabi D.H.
        • Bedi A.
        • Tibor L.M.
        • Magennis E.
        • Kelly B.T.
        The demographic characteristics of high-level and recreational athletes undergoing hip arthroscopy for femoroacetabular impingement: A sports-specific analysis.
        Arthroscopy. 2014; 30: 398-405
        • Roels P.
        • Agricola R.
        • Oei E.H.
        • Weinans H.
        • Campoli G.
        • Zadpoor A.A.
        Mechanical factors explain development of cam-type deformity.
        Osteoarthritis Cartilage. 2014; 22: 2074-2082
        • Mascarenhas V.V.
        • Rego P.
        • Dantas P.
        • et al.
        Imaging prevalence of femoroacetabular impingement in symptomatic patients, athletes, and asymptomatic individuals: A systematic review.
        Eur J Radiol. 2016; 85: 73-95
        • Nepple J.J.
        • Vigdorchik J.M.
        • Clohisy J.C.
        What is the association between sports participation and the development of proximal femoral cam deformity? A systematic review and meta-analysis.
        Am J Sports Med. 2015; 43: 2833-2840
        • Beaulieu M.L.
        • Oh Y.K.
        • Bedi A.
        • Ashton-Miller J.A.
        • Wojtys E.M.
        Does limited internal femoral rotation increase peak anterior cruciate ligament strain during a simulated pivot landing?.
        Am J Sports Med. 2014; 42: 2955-2963
        • Beaulieu M.L.
        • Wojtys E.M.
        • Ashton-Miller J.A.
        Risk of anterior cruciate ligament fatigue failure is increased by limited internal femoral rotation during in vitro repeated pivot landings.
        Am J Sports Med. 2015; 43: 2233-2241
        • Bedi A.
        • Warren R.F.
        • Wojtys E.M.
        • et al.
        Restriction in hip internal rotation is associated with an increased risk of ACL injury.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 2024-2031
        • VandenBerg C.
        • Crawford E.A.
        • Sibilsky Enselman E.
        • Robbins C.B.
        • Wojtys E.M.
        • Bedi A.
        Restricted hip rotation is correlated with an increased risk for anterior cruciate ligament injury.
        Arthroscopy. 2017; 33: 317-325
        • Amenabar T.
        • O’Donnell J.
        Return to sport in Australian football league footballers after hip arthroscopy and midterm outcome.
        Arthroscopy. 2013; 29: 1188-1194
        • Byrd J.W.T.
        • Jones K.S.
        Hip arthroscopy in high-level baseball players.
        Arthroscopy. 2015; 31: 1507-1510
        • Domb B.G.
        • Dunne K.F.
        • Martin T.J.
        • et al.
        Patient reported outcomes for patients who returned to sport compared with those who did not after hip arthroscopy: Minimum 2-year follow-up.
        J Hip Preserv Surg. 2016; 3: 124-131
        • Levy D.M.
        • Kuhns B.D.
        • Frank R.M.
        • et al.
        High rate of return to running for athletes after hip arthroscopy for the treatment of femoroacetabular impingement and capsular plication.
        Am J Sports Med. 2017; 45: 127-134
        • Weber A.E.
        • Kuhns B.D.
        • Cvetanovich G.L.
        • Grzybowski J.S.
        • Salata M.J.
        • Nho S.J.
        Amateur and recreational athletes return to sport at a high rate following hip arthroscopy for femoroacetabular impingement.
        Arthroscopy. 2017; 33: 748-755
        • Domb B.G.
        • Stake C.E.
        • Finch N.A.
        • Cramer T.L.
        Return to sport after hip arthroscopy: aggregate recommendations from high-volume hip arthroscopy centers.
        Orthopedics. 2014; 37: e902-e905
        • Callaghan J.J.
        • Rosenberg A.G.
        • Rubash H.E.
        The Adult Hip.
        Lippincott Williams & Wilkins, Philadelphia, PA2007
        • Levy D.M.
        • Kuhns B.D.
        • Chahal J.
        • Philippon M.J.
        • Kelly B.T.
        • Nho S.J.
        Hip arthroscopy outcomes with respect to patient acceptable symptomatic state and minimal clinically important difference.
        Arthroscopy. 2016; 32: 1877-1886
        • Packer J.D.
        • Safran M.R.
        The etiology of primary femoroacetabular impingement: Genetics or acquired deformity?.
        J Hip Preserv Surg. 2015; 2: 249-257
        • Kowalczuk M.
        • Yeung M.
        • Simunovic N.
        • Ayeni O.R.
        Does femoroacetabular impingement contribute to the development of hip osteoarthritis? A systematic review.
        Sports Med Arthrosc Rev. 2015; 23: 174-179
        • 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; 417: 112-120
        • Malviya A.
        • Paliobeis C.P.
        • Villar R.N.
        Do professional athletes perform better than recreational athletes after arthroscopy for femoroacetabular impingement?.
        Clin Orthop Relat Res. 2013; 471: 2477-2483
        • Tjong V.K.
        • Cogan C.J.
        • Riederman B.D.
        • Terry M.A.
        A qualitative assessment of return to sport after hip arthroscopy for femoroacetabular impingement.
        Orthop J Sports Med. 2016; 4 (2325967116671940)
        • Naal F.D.
        • Schär M.
        • Miozzari H.H.
        • Nötzli H.P.
        Sports and activity levels after open surgical treatment of femoroacetabular impingement.
        Am J Sports Med. 2014; 42: 1690-1695
      1. Memon M, Kay J, Hache P, et al. Athletes experience a high rate of return to sport following hip arthroscopy [published online April 7, 2018]. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-018-4929-z.

        • Perets I.
        • Craig M.J.
        • Mu B.H.
        • Maldonado D.R.
        • Litrenta J.M.
        • Domb B.G.
        Midterm outcomes and return to sports among athletes undergoing hip arthroscopy.
        Am J Sports Med. 2018; 46: 1661-1667
        • Brunner A.
        • Horisberger M.
        • Herzog R.F.
        Sports and recreation activity of patients with femoroacetabular impingement before and after arthroscopic osteoplasty.
        Am J Sports Med. 2009; 37: 917-922
        • Anthony C.A.
        • Pugely A.J.
        • Gao Y.
        • et al.
        Complications and risk factors for morbidity in elective hip arthroscopy: A review of 1325 cases.
        Am J Orthop. 2017; 46: E1-E9
        • Truntzer J.N.
        • Hoppe D.J.
        • Shapiro L.M.
        • Abrams G.D.
        • Safran M.
        Complication rates for hip arthroscopy are underestimated: A population-based study.
        Arthroscopy. 2017; 33: 1194-1201
        • Weber A.E.
        • Harris J.D.
        • Nho S.J.
        Complications in hip arthroscopy: A systematic review and strategies for prevention.
        Sports Med Arthrosc Rev. 2015; 23: 187-193

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