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Mid to Long-Term Outcomes And Survivorship of Athletes Undergoing Primary Hip Arthroscopy: A Systematic Review

Mid to Long-Term Outcomes And Survivorship of Athletes Undergoing Primary Hip Arthroscopy: A Systematic Review

Andrew Jimenez, MD, UNITED STATES Michael Lee, BA, UNITED STATES Jade S Owens, BS, UNITED STATES Scott Fong, BA, UNITED STATES David Kim, BS, UNITED STATES Jay Moran, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Ronak Mahatme, BS, UNITED STATES Jacquelyn Simington, BS, UNITED STATES Peter Monahan, BS, UNITED STATES Seyi Abu, UNITED STATES

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut , UNITED STATES


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Sports Medicine


Summary: Survivorship and Outcomes of Athletes Undergoing Primary Hip Arthroscopy


Background

There is a paucity of literature regarding aggregate midterm outcomes and survivorship after primary hip arthroscopy in the athlete population.

Purpose

The purpose of this study is to evaluate minimum 5-year outcomes and survivorship after primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS).

Methods

A systematic review of current literature was performed with the following keywords: “hip arthroscopy,” “long-term,” “outcomes,” “ten-year,” “survivorship,” “10-year,” “5-year,” “five-year,” “midterm,” “athlete,” “sport,” and “femoroacetabular impingement” in PubMed, Cochrane, and Scopus in April 2022 using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Study and demographic variables such as title, author, publication date, study design, demographic, number of hips, follow-up time, study period, indications for hip arthroscopy, patient-reported outcome scores (PROs), and rates of secondary surgeries and conversion to total hip arthroplasty (THA). Radiographic, intraoperative surgical treatment, and clinical benefit was documented as well.

Results

Ten studies that captured data on 691 hips were included in this study. Six studies had level IV evidence and four studies had level III evidence. Follow-up ranged from 60 months to 14 years. Femoroacetabular impingement syndrome (FAIS) was the most common surgical indication and cited in nine out of 10 studies. Eight out of 10 studies reported athlete sport-type and all sport classifications were present in the study. All 10 studies reported PROs and rates of achieving psychometric thresholds. Nine out of 10 studies reported achieving at least one psychometric threshold at a rate of least 75% . Rates of secondary arthroscopy and conversion to THA varied from 0% - 15.2% and 0% - 33.3%.

Conclusion

Patients who underwent primary hip arthroscopy demonstrated favorable outcomes and high rates of clinical benefit at midterm follow-up. Additionally, they demonstrated high rates of survivorship. The most common indication for surgery was FAIS and secondary arthroscopy and conversion to THA rates varied considerably across studies.


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