Researchers explored return to sport in athletes with borderline hip dysplasia after hip arthroscopy for femoroacetabular impingement syndrome (FAIS).
How Does Borderline Hip Dysplasia Affect FAIS Surgery Outcomes?
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They found that 75.6% of the patients were able to successfully return to sport; slightly less than half returned at the same level and 3.2% at a higher activity level.
Their study, “Return to Sport in Athletes With Borderline Hip Dysplasia After Hip Arthroscopy for Femoroacteabular Impingement Syndrome,” was published online on November 26, 2021 in The American Journal of the Sports Medicine.
The researchers wrote, “Data on outcomes in patients with borderline hip dysplasia who undergo hip arthroscopy remain limited, particularly in regard to return to sport.”
They evaluated outcomes in patients with borderline hip dysplasia and their ability to return to sport after hip arthroscopy for treatment of femoroacetabular impingement syndrome.
The study included athletes with radiographic evidence of borderline hip dysplasia characterized by a lateral femoral center-edge angle between 18˚and 25˚and Tönnis angle >10°. They all underwent hip arthroscopy for femoroacetabular impingement syndrome between November 2014 and March 2017.
Researchers collected data on patient characteristics and clinical outcomes, including the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale, modified Harris Hip Score, International Hip Outcome Tool, and Visual Analog Scale at minimum 2-year follow-up. All the patients also completed a return to sport survey.
The study included 41 patients with a mean age and body mass index of 29.6 ± 13.4 years and 25.3 ± 5.6, respectively. Mean LCEA (lateral femoral center-edge angle) and Tönnis angle for the study population were 22.7°± 1.8° and 13.3°± 2.9°, respectively.
Thirty-one patients were able to return to sport after the surgery at a mean of 8.3 ±3.2 months. Fourteen patients were able to return to their sport at their same performance level, 16 patients returned to a lower level activity and only 1 of them returned to a higher level of activity. Of the 11 high school and collegiate athletes, 10 of them were able to return to sports.
All of the patients showed significant improvements in all patient-reported outcome measures as well as in pain scores at a mean of 26.1 ± 5.4 months after surgery.
Patients who were able to return to sport had a lower preoperative bone mass index than patients who did not return to sport. At the minimum 2-year follow-up, all the patient-reported outcomes were improved compared with those of the patients who did not return to sport (p < .05).
The study authors included Thomas D. Alter, Derrick M. Knapik, M.D., Reagan S. Chapman, Ian M. Clapp, M.D., Nicholas A. Trasolini, M.D., Jorge Chahla, M.D., Shane J. Nho, M.D., all of Rush University Medical Center in Chicago, Illinois.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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