2017 ISAKOS Biennial Congress ePoster #705

 

A Qualitative Assessment of Return to Sport Following Hip Arthroscopy for Femoroacetabular Impingement

Vehniah K. Tjong, MD, FRCSC, Chicago, IL UNITED STATES
Charles Cogan, BSc, Chicago, IL UNITED STATES
Brett Reidermann, BSc, Chicago, IL UNITED STATES
Michael Terry, MD, Chicago, IL UNITED STATES

Northwestern University, Chicago, IL, UNITED STATES

FDA Status Not Applicable

Summary

Self-motivation, aging and pain, encouragement from others, and adapting to physical limitations can largely affect a patient’s decision to return to sport following arthroscopic hip surgery for femoroacetabular impingement

Abstract

Background

Hip arthroscopy for femoroacetabular impingement is known to have excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semi-structured patient interviews on the population of patients who have hip labral tears.

Purpose

To understand the factors influencing the decision to return to sport following arthroscopic hip surgery for femoroacetabular impingement.

Study Design: Mixed Methods (Qualitative and Quantitative) Cross-Sectional Study

Methods

An experienced interviewer conducted qualitative, semi-structured interviews of patients aged 18-60 who had arthroscopic hip surgery for femoroacetabular impingement. All had preinjury participation in sport and a minimum 2-year follow-up with no revision surgery. Qualitative analysis was then performed to derive codes, categories, and themes. An assessment of preinjury and current sports participation by type, level of competition, and frequency, along with patient reported hip function was also obtained. In addition, current modified Harris Hip Score (mHHS), international Hip Outcome Tool (iHOT-12), the sports specific hip outcome score (HOS-SSS), and a coping mechanism evaluation (Brief COPE) were also recorded.

Results

Twenty-three patients were interviewed to reveal the overarching themes of internal motivation, external encouragement, and resetting expectations as the predominant factors influencing a patient’s decision to return to preinjury sport. Subjective hip outcome scores (mHHS, iHOT-12, patient satisfaction) showed significant differences between patients in the two groups. Interestingly, the adaptive and maladaptive coping mechanisms matched and supported our themes in those patients who described fear and self-motivation as defining features influencing their cessation or return to play.

Conclusions

Self-motivation, aging and pain, encouragement from others, and adapting to physical limitations can largely affect a patient’s decision to return to sport following arthroscopic hip surgery for femoroacetabular impingement. Innate coping mechanisms may also help to predict the course of and subsequently aid in a patient’s post-operative recovery.