Background:

Return to sports (RTS) and patient-reported outcomes (PROs) for high-level athletes after bilateral hip arthroscopy have not been well established.

Purpose:

(1) To report minimum 2-year PROs and RTS rates in high-level athletes who underwent staged bilateral primary hip arthroscopies and (2) to compare clinical results against a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were prospectively collected and retrospectively reviewed for high-level athletes (professional, college, or high school) who underwent staged bilateral hip arthroscopy for femoroacetabular impingement syndrome between September 2009 and October 2018. Inclusion criteria were preoperative and minimum 2-year follow-up for modified Harris Hip Score, Non-arthritic Hip Score, Hip Outcome Score–Sports Specific Subscale (HOS-SSS), and visual analog scale for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle <18°), and previous ipsilateral hip surgery/conditions. Rates of achieving the minimal clinically important difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold were recorded in addition to RTS. These athletes were then propensity matched in a 1:3 ratio to high-level athletes who underwent unilateral arthroscopy for comparison. Outcomes were compared among the first hip of the study group, the second hip of the study group, and the control group.

Results:

A total of 74 high-level athletes who underwent bilateral hip arthroscopy met the inclusion criteria, and follow-up was available for 68 (91.9%) at 58.9 ± 24.5 months (mean ± SD). Athletes undergoing bilateral hip arthroscopy returned to sports at a high rate (81.7%), demonstrated significant improvements in all recorded PROs, and achieved the MCID and PASS for the HOS-SSS at rates of 80.9% and 64.7%, respectively. PROs, RTS rate, and rates of achieving the MCID and PASS for the HOS-SSS were similar when the bilateral study group was compared with the unilateral control group (P > .05).

Conclusion:

High-level athletes who undergo staged bilateral primary hip arthroscopy for femoroacetabular impingement syndrome may expect favorable PROs and RTS rates at minimum 2-year follow-up. These results were comparable with those of a propensity-matched control group of high-level athletes who underwent unilateral primary hip arthroscopy.

中文翻译：

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高水平运动员的双侧髋关节镜检查的回归运动和至少 2 年的结果与单侧对照组的倾向匹配基准

背景：

双侧髋关节镜术后高水平运动员的运动恢复 (RTS) 和患者报告结果 (PRO) 尚未确定。

目的：

(1) 报告接受分期双侧初次髋关节镜检查的高水平运动员的最低 2 年 PROs 和 RTS 率，以及 (2) 将临床结果与接受单侧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关节镜检查。

学习规划：

队列研究；证据等级，3。

方法：

前瞻性收集并回顾性审查了 2009 年 9 月至 2018 年 10 月期间因股骨髋臼撞击综合征接受双侧髋关节镜手术的高水平运动员（专业、大学或高中）的数据。纳入标准为术前和至少 2 年的随访用于改良 Harris 髋关节评分、非关节炎髋关节评分、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。排除标准为 Tönnis 等级 >1、髋关节发育不良（外侧中心边缘角 <18°）和先前的同侧髋关节手术/状况。除了 RTS 之外，还记录了达到最小临床重要差异 (MCID)、患者可接受的症状状态 (PASS) 和最大结果改善满意度阈值的比率。然后将这些运动员与接受单侧关节镜检查的高水平运动员按 1:3 的比例进行倾向匹配。比较研究组第一髋、研究组第二髋和对照组的结果。

结果：

共有 74 名接受双侧髋关节镜检查的高水平运动员符合纳入标准，并且在 58.9 ± 24.5 个月（平均值 ± SD）时可随访 68 名（91.9%）。接受双侧髋关节镜检查的运动员以高比率 (81.7%) 恢复运动，所有记录的 PRO 均显示出显着改善，并分别以 80.9% 和 64.7% 的比率实现了 HOS-SSS 的 MCID 和 PASS。当双侧研究组与单侧对照组比较时，HOS-SSS 的 PRO、RTS 率以及实现 MCID 和 PASS 的比率相似（P > .05）。

结论：

因股骨髋臼撞击综合征而接受双侧初次髋关节镜检查的高水平运动员可能会在至少 2 年的随访中获得有利的 PRO 和 RTS 率。这些结果与接受单侧初次髋关节镜检查的高水平运动员的倾向匹配对照组的结果相当。