Low Back Pain Irrelevant to Return to Sport After Hip Arthroscopy

Athletes who have low back pain and have gone through hip arthroscopy for femoroacetabular impingement syndrome (FAIS) have no significant differences in return to sport or patient-reported outcomes.

In the study, “Return to Sports and Minimum 2-Year Outcomes of Hip Arthroscopy in Elite Athletes With and Without Coexisting Low Back Pain: A Propensity-Matched Comparison,” published online on November 22, 2021 in The American Journal of Sports Medicine, the researchers compare the results of elite athletes with low back pain and those without it after hip arthroscopy.

“Patient-reported outcomes and return to sports after hip arthroscopy for femoroacetabular impingement syndrome have not been established in elite athletes with coexisting low back pain,” they wrote.

For the study, the team collected data for both college and professional elite athletes who had been treated for femoroacetabular impingement syndrome arthroscopically and also had coexisting low back pain between October 2009 and October 2018.

The research team included patients with preoperative and minimum 2-year follow-up for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sports Specific Subscale and Visual Analog Scale.

The team then pulled together data which quantified the rates with which these athletes achieved minimal clinically importance difference, patient acceptable symptomatic state and maximum outcome improvement satisfaction threshold as well as return to sport. Then in a sub analysis, the team propensity-matched the test subjects to elite athletes without back pain.

The elite athletes with coexisting low back pain had significant improvements in all recorded patient-reported outcomes and achieved minimal clinically importance difference and patient acceptable symptomatic state for the Hip Outcome Score-Sports-Specific Subscale at rates of 82.5% and 67.5%, respectively.

They also returned to sports at a high rate (75.8%) and 79% of them did not report low back pain postoperatively. In addition, patient-reported outcomes, rates of achieving the minimal clinically importance difference, and patient acceptable symptomatic state for the Hip Outcome Score-Sports-Specific Subscale and return to sport rates were similar between the two groups.

“Elite athletes with coexisting low back pain who undergo primary hip arthroscopy for femoroacetabular impingement syndrome may expect favorable patient-reported outcomes, high rates of achieving the minimal clinically importance difference and patient acceptable symptomatic state for the Hip Outcome Score-Sports-Specific Subscale and return to sport rates at minimum 2-year follow-up. These results were comparable to those of a propensity-matched control group of elite athletes without back pain. In athletes with hip-spine syndrome, successful treatment of their hip pathology may help resolve their back pain,” the researchers wrote.

The study authors included Andrew E. Jimenez, M.D., Peter F. Monahan, David R. Maldonado, M.D., Benjamin R. Saks, M.D., Payam W. Sabetian, M.D., Hari K. Ankem, M.D., Ajay C. Lall, M.D. and Benjamin G. Domb, M.D. of the American Hip Institute Research Foundation.