Advertisement

Athletes Report Favorable Outcomes At 5 Year Minimum Follow-up After Primary Hip Arthroscopy: A Systematic Review

Published:November 14, 2022DOI:https://doi.org/10.1016/j.arthro.2022.11.008

      Abstract

      Purpose

      The purpose of this study is to evaluate minimum 5-year outcomes and survivorship after primary hip arthroscopy in athletes.

      Methods

      A systematic review of current literature was performed with the following keywords: “hip arthroscopy,” “long-term,” “outcomes,” “ten-year,” “survivorship,” “10-year,” “5-year,” “five-year,” “midterm,” “athlete,” “sport,” and “femoroacetabular impingement” in PubMed, Cochrane Trials, and Scopus in April 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Study and demographic variables such as title, author, publication date, study design, demographic, number of hips, follow-up time, study period, indications for hip arthroscopy, patient-reported outcome scores (PROs), and rates of secondary surgeries and conversion to total hip arthroplasty (THA). Radiographic, intraoperative surgical treatment, and clinical benefit was documented as well.

      Results

      Ten studies that captured data on 691 hips were included in this study. Eight studies reported mean and standard deviation for the mHHS., Significant improvements were reported in all studies with postoperative scores ranging from 83.3 - 94.4 (SMD 1.65; 95% CI [1.39, 1.91] p < 0.00001). Eight studies reported significant improvement in HOS-SSS with postoperative scores ranging from 59.2 – 94.6 (SMD 1.66; 95% CI [1.33, 1.98] p < 0.00001). Seven studies reported significant improvement in NAHS with postoperative scores ranging from 79.6 – 95.3 (SMD 1.41; 95% CI [1.16 , 1.65] p <0.00001). Seven studies also reported significant improvement in VAS with postoperative scores ranging from 0.7 – 3.1 (SMD -1.57 95% CI [-1.88 , -1.26] p <0.00001). Nine out of 10 studies reported achieving at least one psychometric threshold at a rate of least 75%. Rates of secondary arthroscopy and conversion to THA varied from 0% - 15.2% and 0% - 33.3%.

      Conclusions

      Athletes who underwent primary hip arthroscopy demonstrated favorable outcomes and high rates of clinical benefit at 5-year follow-up. Additionally, they demonstrated high rates of survivorship and achieving psychometric thresholds.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Menge T.J.
        • Truex N.W.
        Femoroacetabular impingement: a common cause of hip pain.
        Phys Sportsmed. 2018 May; 46: 139-144
        • Röling M.A.
        • Mathijssen N.M.C.
        • Bloem R.M.
        Incidence of symptomatic femoroacetabular impingement in the general population: a prospective registration study.
        J Hip Preserv Surg. 2016; 3: 203-207
        • Safran M.R.
        • Foard S.J.
        • Robell K.
        • Pullen W.M.
        Incidence of Symptomatic Femoroacetabular Impingement: A 4-Year Study at a National Collegiate Athletic Association Division I Institution.
        Orthop J Sports Med. 2022; 1023259671221084980
        • Frank R.M.
        • Ukwuani G.
        • Chahla J.
        • Batko B.
        • Bush-Joseph C.A.
        • Nho S.J.
        High Rate of Return to Swimming After Hip Arthroscopy for Femoroacetabular Impingement.
        Arthroscopy. 2018; 34: 1471-1477
        • Chen S.L.
        • Maldonado D.R.
        • Go C.C.
        • Kyin C.
        • Lall A.C.
        • Domb B.G.
        Outcomes of Hip Arthroscopic Surgery in Adolescents With a Subanalysis on Return to Sport: A Systematic Review.
        Am J Sports Med. 2020; 48: 1526-1534
        • Hassebrock J.D.
        • Makovicka J.L.
        • Chhabra A.
        • Anastasi M.B.
        • Menzer H.M.
        • Wilcox J.G.
        • Economopoulos K.J.
        Hip Arthroscopy in the High-Level Athlete: Does Capsular Closure Make a Difference?.
        Am J Sports Med. 2020 Aug; 48: 2465-2470
        • Hassebrock J.D.
        • Chhabra A.
        • Makovicka J.L.
        • Economopoulos K.J.
        Bilateral Hip Arthroscopy in High-Level Athletes: Results of a Shorter Interval Between Staged Bilateral Hip Arthroscopies.
        Am J Sports Med. 2020; 48: 654-660
        • Jimenez A.E.
        • Fox J.D.
        • Monahan P.F.
        • Lee M.S.
        • George T.
        • Maldonado D.R.
        • Saks B.R.
        • Lall A.C.
        • Domb B.G.
        High Body Mass Index Does Not Adversely Affect Outcomes in High-Level Athletes Undergoing Primary Hip Arthroscopy: A Propensity-Matched Comparison With Minimum 2-Year Follow-up.
        Am J Sports Med. 2022; 50: 507-514
        • Lindman I.
        • Öhlin A.
        • Desai N.
        • et al.
        Five-Year Outcomes After Arthroscopic Surgery for Femoroacetabular Impingement Syndrome in Elite Athletes.
        Am J Sports Med. 2020; 48: 1416-1422
        • Byrd J.W.T.
        • Jones K.S.
        Hip arthroscopy in athletes: 10-year follow-up.
        Am J Sports Med. 2009; 37: 2140-2143
        • Liberati A.
        • Altman D.G.
        • Tetzlaff J.
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.
        J Clin Epidemiol. 2009; 62: e1-34
        • 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
        • Kyin C.
        • Maldonado D.R.
        • Go C.C.
        • Shapira J.
        • Lall A.C.
        • Domb B.G.
        Mid- to Long-Term Outcomes of Hip Arthroscopy: A Systematic Review.
        Arthroscopy. 2021; 37: 1011-1025
        • Slim K.
        • Nini E.
        • Forestier D.
        • Kwiatkowski F.
        • Panis Y.
        • Chipponi J.
        Methodological index for non-randomized studies (minors): development and validation of a new instrument.
        ANZ J Surg. 2003; 73: 712-716
        • Hohmann E.
        • Feldman M.
        • Hunt T.J.
        • Cote M.P.
        • Brand J.C.
        • Pearls Research
        How Do We Establish the Level of Evidence?.
        Arthroscopy. 2018; 34: 3271-3277
        • Menge T.J.
        • Briggs K.K.
        • Dornan G.J.
        • McNamara S.C.
        • Philippon M.J.
        Survivorship and Outcomes 10 Years Following Hip Arthroscopy for Femoroacetabular Impingement: Labral Debridement Compared with Labral Repair.
        J Bone Joint Surg Am. 2017; 99: 997-1004
        • Jimenez A.E.
        • Glein R.M.
        • Owens J.S.
        • Lee M.S.
        • Maldonado D.R.
        • Saks B.R.
        • Lall A.C.
        • Domb B.G.
        Predictors of Achieving the Patient Acceptable Symptomatic State at Minimum 5-Year Follow-up Following Primary Hip Arthroscopy in the Adolescent Athlete.
        J Pediatr Orthop. 2022; 42: e277-e284
        • Jimenez A.E.
        • Monahan P.F.
        • Maldonado D.R.
        • Saks B.R.
        • Ankem H.K.
        • Sabetian P.W.
        • Lall A.C.
        • Domb B.G.
        Comparing Midterm Outcomes of High-Level Athletes Versus Nonathletes Undergoing Primary Hip Arthroscopy: A Propensity-Matched Comparison With Minimum 5-Year Follow-up.
        Am J Sports Med. 2021; 49: 3592-3601
        • Jimenez A.E.
        • Monahan P.F.
        • Owens J.S.
        • Lee M.S.
        • Maldonado D.R.
        • Saks B.R.
        • Ankem H.K.
        • Lall A.C.
        • Domb B.G.
        High-Level Athletes Who Did Not Return to Sport for Reasons Unrelated to Their Hip Achieve Successful Midterm Outcomes With a Benchmarking Against High-Level Athletes Who Returned to Sport.
        Arthroscopy. 2022; 38: 1879-1887
        • Chen A.W.
        • Craig M.J.
        • Yuen L.C.
        • Ortiz-Declet V.
        • Maldonado D.R.
        • Domb B.G.
        Five-Year Outcomes and Return to Sport of Runners Undergoing Hip Arthroscopy for Labral Tears With or Without Femoroacetabular Impingement.
        Am J Sports Med. 2019; 47: 1459-1466
        • Maldonado D.
        • Yelton M.
        • Rosinsky P.
        • et al.
        Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up.
        BMC Musculoskelet Disord. 2020; : 21
        • Menge T.J.
        • Briggs K.K.
        • Rahl M.D.
        • Philippon M.J.
        Hip Arthroscopy for Femoroacetabular Impingement in Adolescents: 10-Year Patient-Reported Outcomes.
        Am J Sports Med. 2021; 49: 76-81
        • Beals T.R.
        • Soares R.W.
        • Briggs K.K.
        • Day H.K.
        • Philippon M.J.
        Ten-Year Outcomes After Hip Arthroscopy in Patients With Femoroacetabular Impingement and Borderline Dysplasia.
        Am J Sports Med. 2022; 50: 739-745
        • Clapp I.M.
        • Nwachukwu B.U.
        • Beck E.C.
        • Jan K.
        • Gowd A.K.
        • Nho S.J.
        Comparing Outcomes of Competitive Athletes Versus Nonathletes Undergoing Hip Arthroscopy for Treatment of Femoroacetabular Impingement Syndrome.
        Am J Sports Med. 2020; 48: 159-166
        • Owens J.S.
        • Jimenez A.E.
        • Lee M.S.
        • Hawkins G.C.
        • Maldonado D.R.
        • Domb B.G.
        Basketball Players Undergoing Primary Hip Arthroscopy Exhibit Higher Grades of Acetabular Cartilage Damage but Achieve Favorable Midterm Outcomes and Return to Sports Rates Comparable With a Propensity-Matched Group of Other Cutting Sports Athletes.
        Am J Sports Med. 2022; 50: 1909-1918
        • Jimenez A.E.
        • Monahan P.F.
        • Owens J.S.
        • Lee M.S.
        • Maldonado D.R.
        • Saks B.R.
        • Ankem H.K.
        • Lall A.C.
        • Domb B.G.
        High-Level Athletes Who Did Not Return to Sport for Reasons Unrelated to Their Hip Achieve Successful Midterm Outcomes With a Benchmarking Against High-Level Athletes Who Returned to Sport.
        Arthroscopy. 2022; 38: 1879-1887
        • Jimenez A.E.
        • George T.
        • Lee M.S.
        • et al.
        Competitive Athletes with Femoroacetabular Impingement and Painful Internal Snapping Treated Arthroscopically with Intrabursal Iliopsoas Fractional Lengthening: High Rate of Return to Sport and Favorable Midterm Functional Outcomes.
        Am J Sports Med. 2022; 50: 1591-1602
        • Konan S.
        • Rayan F.
        • Witt J.
        • Meermans G.
        Validation of the classification system for acetabular chondral lesions identified at arthroscopy in patients with femoroacetabular impingement.
        J Bone Jt Surg. 2011; 93: 332-336