Arthroscopic Hip Treatment Helps Athletes Return to Function

Athletes who undergo arthroscopic surgery for femoro-acetabular impingement (FAI), a mechanical disorder of the hip, have a good chance of being able to return to their sport at a high level of competition, according to a new study.

Researchers at the Hospital for Special Surgery (New York, NY, USA) reviewed the demographic characteristics, X-rays, and data collected during the operations of 47 patients (average age 22.8 years), representing athletes from a variety of sports, including ice hockey, soccer, baseball, swimming, football, and other sports. An independent blinded examiner recorded the athlete's strength after the operation, range of motion, and complications. All patients completed questionnaires that measured hip-specific outcomes including the Modified Harris Hip Score (MHHS) and Hip Outcome Score. The researchers also collected information on how soon athletes were able to return to play, return to competition, and return to the same level of competition they were at before they started having problems. A total of 33 patients (70%) were available for follow-up.

The results showed that 78% of the patients were able to return to play after hip arthroscopy at an average of 9.4 months after surgery, and roughly 91.7% were able to return to the same level of competition. X-rays showed an improvement in the anatomy of the hips, and the investigators identified statistically significant improvements in the average MHHS scores, rising from 68.6 before surgery to 88.5 after; only two patients were unable to return to competition due to persistent hip injury. The study was presented at the annual meeting of the American Orthopedic Society for Sports Medicine, held during July 2010 in Providence (RI, USA).

"Before this study we knew that hip impingement occurred in athletes, but we were not certain as to the degree of our ability to treat this arthroscopically with a successful return to full function,” said Bryan Kelly, M.D., a sports medicine orthopedic surgeon the HSS. "Although technically challenging, appropriately performed arthroscopic surgery results in less soft tissue trauma, less blood loss, shorter hospitalizations, and likely provides a faster return to a full recovery.”

FAI, also known as hip impingement, has become widely recognized in the medical community. In a healthy hip joint, the head of the femur rotates in the acetabulum, but sometimes a bony protrusion on the femur produces a situation where there is inadequate space for the femur to move freely. The result is damage to the socket rim and the cartilage that lines the area, which can lead to hip arthritis. While FAI can affect anyone who is genetically predisposed, symptoms often appear earlier in those who are athletic, and in those who present persistently with complaints of pain, decreased range of motion, and the inability to perform at a high level of competition.

Related Links:
Hospital for Special Surgery