Purpose
To compare minimum 2-year postoperative patient-reported outcome (PRO) scores and
return to sport between competitive athletes undergoing primary hip arthroscopy for
femoroacetabular impingement syndrome with interportal capsulotomy repair and competitive
athletes with an unrepaired interportal capsulotomy.
Methods
Data on all consecutive competitive athletes who underwent primary hip arthroscopy
for femoroacetabular impingement syndrome between February 2012 and December 2018
were collected. Athletes were divided into 2 groups: those who underwent repair and
those without repair. Athletes were considered eligible if they participated in sports
within 1 year prior to surgery. Patients were eligible if the return-to-sport status
and the following preoperative and minimum 2-year postoperative PROs were available:
modified Harris Hip Score, Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific
Subscale (HOS-SSS), and visual analog scale (VAS) score for pain. Patients were excluded
if they underwent prior hip surgery, had Workers’ Compensation, were unwilling to
consent, had a Tönnis grade greater than 1, or had a previous hip condition. The percentages
of patients achieving the minimal clinically important difference (MCID) and maximum
outcome improvement satisfaction threshold were recorded. Athletes who underwent interportal
capsulotomy repair were propensity score matched in a ratio of 2:1 to athletes without
interportal capsulotomy repair according to age, sex, body mass index, sport level,
and acetabular labrum articular disruption grade.
Results
Forty-nine athletes (53 hips) without repair with an average follow-up time of 36.5
± 10.2 months and age of 32.1 ± 13.3 years were matched to 79 athletes (84 hips) with
repair with an average follow-up time of 41.3 ± 9.4 months and age of 30.1 ± 12.1
years. Athletes in the repaired group showed significantly greater improvements in
the NAHS, HOS-SSS, and VAS score and significantly higher rates of achievement of
the MCID for the HOS-SSS compared with athletes in the unrepaired group.
Conclusions
Competitive athletes who underwent primary hip arthroscopy with interportal capsulotomy
repair showed a significantly greater magnitude of improvement in PRO scores (NAHS,
HOS-SSS, and VAS score) and rates of achieving the MCID (HOS-SSS) compared with a
propensity score–matched control group of competitive athletes with an unrepaired
interportal capsulotomy.
Level of Evidence
Level III, retrospective comparative therapeutic trial.
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Article Info
Publication History
Published online: May 10, 2022
Accepted:
April 20,
2022
Received:
January 13,
2022
Footnotes
See commentary on page 3041
The authors report the following potential conflicts of interest or sources of funding: D.R.M. receives travel and lodging support from Arthrex , Stryker , and Smith & Nephew , outside the submitted work; receives food and beverage payments from Arthrex , Stryker , Smith & Nephew , and Össur , outside the submitted work; and is an editorial board member of Arthroscopy. B.G.D. reports that the American Orthopedic Foundation provides grant support that pays staff and expenses related to all research. In addition, B.G.D. receives consulting fees from Arthrex, Medacta, and Stryker; receives research support from ATI Physical Therapy ; receives research and education support from Arthrex , Medacta , and Stryker ; receives educational support from Arthrex , Breg , Medwest Associates , St. Alexius Medical Center , and Ossur; receives royalties from Amplitude, Arthrex , DJO Global , Medacta , Stryker , and Orthomerica ; receives speaking fees from Arthrex; receives travel and lodging support from Arthrex , Medacta , Stryker , and Prime Surgical ; receives food and beverage payments from Arthrex , DJO Global , Medacta , Stryker , Zimmer Biomet , DePuy Synthes Sales , Medtronic , and Trice Medical ; receives honoraria from Medacta; receives nonconsulting fees from Stryker; and has a medical directorship with St. Alexius Medical Center, outside the submitted work. Moreover, B.G.D. has patents issued and receives royalties for the following: method and instrumentation for acetabular labrum reconstruction (8920497), licensed by Arthrex; adjustable multi-component hip orthosis (8708941), licensed by Orthomerica and DJO Global; and knotless suture anchors and methods of suture repair (9737292), licensed by Arthrex. Finally, B.G.D. is a board member of the American Hip Institute Research Foundation, AANA Learning Center Committee, Journal of Hip Preservation Surgery, and Arthroscopy and has had ownership interests in the American Hip Institute, Hinsdale Orthopedic Associates, Hinsdale Orthopedic Imaging, SCD#3, North Shore Surgical Suites, and Munster Specialty Surgery Center. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
