IOA 2022

Intra-articular Damage and Patient Outcome Comparison between Athletes and Non-athletes Following Hip Arthroscopy

Jackob Shapira 1 Mitch Yelton 1 Rachel Glein 1 Phillip Rosinsky 1 Hari Ankem 1 Ajay Lall 1,2 Benjamin Domb 1,2
1Orthopedics, American Hip Institute Research Foundation, USA
2Orthopedics, American Hip Institute, USA

Purpose:
(1) compare the intra-articular damage at the time of the hip arthroscopy between athletes and non-athletes and (2) to compare the pre- and postoperative outcomes between the groups.

Methods:
Patients eligible for analysis if they had received primary arthroscopy, were participating in competitive athletics, and had preoperative baseline scores and minimum 2-year follow-up for the following patient reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale (VAS). Propensity score matching was utilized in a 1:1 ratio to patients who were not participating in any sports greater than a recreational level prior to surgery.

Results:
A total of 234 patients were included. There were no significant differences in regarding the severity of labral tears, ligamentum teres tears, of cartilage damage (P > 0.05). The procedures performed between cohorts were similar (P > 0.05). The athletic population had higher preoperative means for mHHS and NAHS (P < 0.001, P < 0.001). Likewise, the athletic population had higher postoperative means for NAHS, HOS-SSS, and VAS (P = 0.031, P = 0.030, and P = 0.032 respectively). Additionally, the athletic cohort reported higher minimum 2-year outcomes compared to the non-athletic cohort for SF-12M, VR-12M, and VR-12P (P = 0.003, P = 0.032, and P = 0.005, respectively).

Conclusion:
At the time of hip arthroscopy, athletes demonstrate similar intra-articular damage to their non-athlete counterparts. Considering their higher preoperative scores, it is possible that athletes better tolerate the damage to the hip joint and maintain higher functional level in spite of comparable pathology. Provided that athletes are diagnosed and treated, no significantly excessive damage should be expected despite the anticipated correlation between strenuous activity and mechanical symptoms.