Endoscopic Pubic Symphysectomy for Refractory Osteitis Pubis Provides Positive Functional Outcomes and High Return-to-Sport Rate at a Minimum 2-Year Follow-Up.

PURPOSE: To evaluate the outcomes of endoscopic pubic symphysectomy as a treatment for refractory osteitis pubis with a minimum 2-year follow-up, and to present a return-to-sport (RTS) subanalysis of this patient population.

METHODS

Prospectively collected data were retrospectively analyzed for patients who underwent endoscopic pubic symphysectomy as treatment for osteitis pubis between May 2012 and September 2021. Included patients had completed preoperative and a minimum of 2-year postoperative questionnaires for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports-Specific Subscale, International Hip Outcome Tool (iHOT-12), visual analog scale, and patient satisfaction. The minimal clinically important difference was calculated for the mentioned patient-reported outcomes and included in the analysis. For the subanalysis, sport participation was defined as participation within 1 year of surgery, and RTS rates were calculated for the overall cohort and for the subset of patients who attempted to return postoperatively.

RESULTS

A total of 14 (93.3%) out of 15 patients were included in the study. All patients experienced symptom relief with a significant improvement in mHHS (P < .05), NAHS (P < .05), iHOT-12 (P < .01), and a high patient satisfaction rate with a mean satisfaction of 8.5 ± 2.7. A high percentage of patients reached the calculated minimal clinically important difference for mHHS, NAHS, Hip Outcome Score-Sports-Specific Subscale, and iHOT-12. Twelve patients (85.7%) reported sports participation. The overall RTS rate was 75%. Of the 9 patients who attempted to return, all (100%) successfully resumed sport within 1 year postoperatively, while 3 (25%) patients chose not to attempt RTS due to a desire to prevent symptoms.

CONCLUSIONS

Endoscopic pubic symphysectomy for refractory cases of osteitis pubis yielded significant improvement in mHHS, NAHS, iHOT-12, and a high patient satisfaction, reaching clinical important thresholds at a high rate at a minimum 2-year follow-up. All patients who attempted to return to sport were able to return to sport participation within 1 year of the surgery.

LEVEL OF EVIDENCE: Level IV, retrospective case series.