Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2026
Successful Long-Term Outcomes and Continuation of Sport in Competitive Athletes, 10 Years Following Hip Arthroscopy for Femoroacetabular Impingement.
СтатьяНазвание и аннотация: Перевод в очереди
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Mullins Karen, Filan David, Carton Patrick
Аннотация
PURPOSE: To quantify the long-term outcomes following hip arthroscopy for symptomatic femoroacetabular impingement (FAI) in athletes.
METHODS: Competitive athletes who underwent primary arthroscopy for FAI between January 2009 and October 2013 were evaluated at 10-year follow-up (mean 121 ± 6 months). Conversions to total hip replacement (THR) and revision arthroscopies were recorded. For those without additional surgery, current sporting activity was categorized as Full Pain-Free Participation, Full Participation Despite Pain, Modified Activity, or No Activity. Patient-reported outcome measures (PROMs) (modified Harris Hip Score (mHHS), University of California, Los Angeles activity scale (UCLA), 36-Item Short Form Health Survey (SF36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were collected at baseline and follow-up and compared using Wilcoxon Signed Ranks tests. The patient acceptable symptom state (PASS) was assessed via an anchor question and thresholds for each PROM, above which would indicate PASS achievement were quantified. Patient satisfaction was also determined from the PASS anchor question and compared across sporting groups.
RESULTS: One hundred thirty-two athletes met the inclusion. The mean age was of 28 ± 7 years and 118 were male (89%). At 10 years, 12 (9.1%) converted to THR, and 22 (16.7%) had revision arthroscopy. Among 98 athletes without additional surgery, 77 reported current activity: 64 (83.1%) remained active; 33 (51.5%) Full Pain-Free, 4 (6.3%) Despite Pain, and 27 (42.2%) Modified Activity. Thirteen (16.9%) ceased regular sport: 5 (38.5%) due to hip symptoms, 4 (30.8%) due to other conditions, 3 (23.1%) due to lifestyle, 1 (7.7%) gave no reason. Significant improvements were seen in mHHS and SF36 (P < .05). There was no statistical difference noted for WOMAC or UCLA scores (P > .05). PASS achievement thresholds for mHHS, UCLA, SF36, and WOMAC were 83, 9, 84, and 11 and achieved by 80%, 64%, 67%, and 72% respectively; 81% reported satisfaction, with higher rates in Full Pain-Free group (P < .001) compared with other sporting categories.
CONCLUSIONS: At 10 years, 9.1% of athletes required THR, while 16.7% required a revision arthroscopy. In patients not requiring secondary surgery, 83% of athletes continued to play sport. The results indicate high survivorship and participation in sport 10 years following arthroscopy for FAI in an athletic cohort.
LEVEL OF EVIDENCE: Level IV, case series.
METHODS: Competitive athletes who underwent primary arthroscopy for FAI between January 2009 and October 2013 were evaluated at 10-year follow-up (mean 121 ± 6 months). Conversions to total hip replacement (THR) and revision arthroscopies were recorded. For those without additional surgery, current sporting activity was categorized as Full Pain-Free Participation, Full Participation Despite Pain, Modified Activity, or No Activity. Patient-reported outcome measures (PROMs) (modified Harris Hip Score (mHHS), University of California, Los Angeles activity scale (UCLA), 36-Item Short Form Health Survey (SF36), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)) were collected at baseline and follow-up and compared using Wilcoxon Signed Ranks tests. The patient acceptable symptom state (PASS) was assessed via an anchor question and thresholds for each PROM, above which would indicate PASS achievement were quantified. Patient satisfaction was also determined from the PASS anchor question and compared across sporting groups.
RESULTS: One hundred thirty-two athletes met the inclusion. The mean age was of 28 ± 7 years and 118 were male (89%). At 10 years, 12 (9.1%) converted to THR, and 22 (16.7%) had revision arthroscopy. Among 98 athletes without additional surgery, 77 reported current activity: 64 (83.1%) remained active; 33 (51.5%) Full Pain-Free, 4 (6.3%) Despite Pain, and 27 (42.2%) Modified Activity. Thirteen (16.9%) ceased regular sport: 5 (38.5%) due to hip symptoms, 4 (30.8%) due to other conditions, 3 (23.1%) due to lifestyle, 1 (7.7%) gave no reason. Significant improvements were seen in mHHS and SF36 (P < .05). There was no statistical difference noted for WOMAC or UCLA scores (P > .05). PASS achievement thresholds for mHHS, UCLA, SF36, and WOMAC were 83, 9, 84, and 11 and achieved by 80%, 64%, 67%, and 72% respectively; 81% reported satisfaction, with higher rates in Full Pain-Free group (P < .001) compared with other sporting categories.
CONCLUSIONS: At 10 years, 9.1% of athletes required THR, while 16.7% required a revision arthroscopy. In patients not requiring secondary surgery, 83% of athletes continued to play sport. The results indicate high survivorship and participation in sport 10 years following arthroscopy for FAI in an athletic cohort.
LEVEL OF EVIDENCE: Level IV, case series.