Background:

Outcomes of revision hip arthroscopy in the athletic population have not been well established.

Purpose:

(1) To report clinical outcomes for high-level athletes undergoing revision hip arthroscopy in the setting of femoroacetabular impingement syndrome (FAIS) or labral tears and (2) to compare these outcomes against a propensity-matched group of high-level athletes undergoing primary hip arthroscopy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data for professional, college, and high school athletes were prospectively collected and retrospectively reviewed between January 2012 and October 2018. Patients were included if they underwent revision or primary hip arthroscopy and had preoperative and minimum 2-year patient-reported outcome (PRO) scores for modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. The findings and outcomes of revision athletes were compared with a propensity-matched control group of high-level athletes undergoing primary hip arthroscopy.

Results:

A total of 32 hips (29 patients) undergoing revision hip arthroscopy and 92 hips (88 patients) undergoing primary hip arthroscopy were included in our final analysis with a median follow-up time of 29.5 months (95% CI, 27.2-32.1 months) and 36.5 months (95% CI, 33.5-37.7 months), respectively. Athletes undergoing revision surgery showed significant improvement in all recorded PRO measurements and achieved patient acceptable symptomatic state (PASS) and minimal clinically important difference (MCID) for mHHS at high rates (80.6% and 83.9%, respectively). When compared with a propensity-matched primary control group, patients undergoing revision surgery demonstrated lower preoperative and postoperative scores for mHHS, NAHS, and HOS-SSS, but the magnitude of improvement in functional scores was similar between groups. Athletes undergoing revision surgery achieved PASS for HOS-SSS at lower rates than the control group (P = .005), and they were less likely to attempt to return to sport compared with the control group (62.5% vs 87.0%; P < .01).

Conclusion:

Revision hip arthroscopy is a viable treatment option to improve PROs in high-level athletes at minimum 2-year follow-up. The study group showed significant improvement in functional scores and a high rate of successful outcomes. They experienced similar magnitude of improvement as that of a propensity-matched control group; however, they achieved lower postoperative PRO scores and attempted to return to sport at lower rates.

中文翻译：

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高水平运动员的髋关节镜翻修：与倾向匹配的初级髋关节镜控制组的最少 2 年结果比较

背景：

运动人群中翻修髋关节镜检查的结果尚未确定。

目的：

(1) 报告在股骨髋臼撞击综合征 (FAIS) 或盂唇撕裂的情况下接受翻修髋关节镜检查的高水平运动员的临床结果，以及 (2) 将这些结果与接受初级髋关节置换术的高水平运动员的倾向匹配组进行比较髋关节镜检查。

学习规划：

队列研究；证据等级，3。

方法：

专业、大学和高中运动员的数据在 2012 年 1 月至 2018 年 10 月期间进行了前瞻性收集和回顾性审查。如果患者接受了翻修或初次髋关节镜检查，并且具有术前和最低 2 年患者报告结果 (PRO) 评分，则包括在内用于修正 Harris 髋关节评分 (mHHS)、非关节炎髋关节评分 (NAHS)、髋关节结果评分运动特定分量表 (HOS-SSS) 和疼痛的视觉模拟量表 (VAS)。将翻修运动员的发现和结果与接受初次髋关节镜检查的高水平运动员的倾向匹配对照组进行比较。

结果：

共有 32 髋（29 名患者）接受翻修髋关节镜检查和 92 髋（88 名患者）接受初次髋关节镜检查，中位随访时间为 29.5 个月（95% CI，27.2-32.1 个月）。和 36.5 个月（95% CI，33.5-37.7 个月）。接受翻修手术的运动员在所有记录的 PRO 测量值中均显示出显着改善，并以高比率（分别为 80.6% 和 83.9%）实现了患者可接受的症状状态 (PASS) 和最小的 mHHS 临床重要差异 (MCID)。与倾向匹配的主要对照组相比，接受翻修手术的患者的术前和术后 mHHS、NAHS 和 HOS-SSS 评分较低，但组间功能评分的改善程度相似。P = .005），并且与对照组相比，他们尝试恢复运动的可能性较小（62.5% vs 87.0%；P < .01）。

结论：

翻修髋关节镜是一种可行的治疗选择，可在至少 2 年的随访中改善高水平运动员的 PRO。研究组显示出功能评分的显着改善和高成功率。他们经历了与倾向匹配的对照组相似的改善幅度；然而，他们的术后 PRO 评分较低，并试图以较低的速度恢复运动。