Background:

Master athletes (MAs), or athletes older than 40 years, make up a patient population whose outcomes after primary arthroscopic hip surgery are largely unknown.

Purpose:

To report minimum 2-year outcomes of MAs after primary hip arthroscopy and compare their results to a propensity-matched nonathlete (NA) control group.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were prospectively collected between February 2008 and April 2019 and retrospectively reviewed for all patients who underwent primary hip arthroscopy. Patients were included if they were older than 40 years and had preoperative data for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, and visual analog scale score for pain. MAs reported participating in organized sports competition within 1 year before surgery and were propensity matched to a control group of patients who did not report participating in organized sports competition (NAs). Patient characteristics, radiographic and intraoperative findings, surgical procedures performed, and patient-reported outcome measures (PROMs) were reported and compared between the groups. The rates of achieving the minimal clinically important difference and maximum outcome improvement satisfaction threshold were recorded.

Results:

A total of 366 hips were eligible; 328 (89.6%) had adequate follow-up data. 328 patients met inclusion criteria but 88 were not included due to the restrictions of the propensity score match ratio. Of these, 80 hips (76 patients) were classified as MAs (mean age, 48.9 ± 6.2 years) and were propensity matched 1:2 to an NA control group. Groups were comparable for baseline demographic and radiographic parameters, intraoperative findings, and procedures performed. MAs had significantly better baseline and minimum 2-year PROM scores (P < .05), higher satisfaction (P = .01), and higher rates of achieving clinically meaningful improvement across all the outcome tools used (P < .05). MAs, when compared with NAs, had lower rates of secondary arthroscopy (0% vs 7.5%, respectively; P = .001) and conversion to total hip arthroplasty (12.5% vs 26.9%, respectively; P = .011).

Conclusion:

MAs demonstrated favorable outcomes after primary hip arthroscopy. When compared with a propensity score–matched control group of NA patients, MAs demonstrated better preoperative and postoperative PROMs, higher rates of clinically meaningful improvement, and lower rates of secondary arthroscopy and conversion to total hip arthroplasty. Absolute improvements in PROM scores were similar between the groups.

中文翻译：

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与非运动员相比，40 岁以上运动员初次髋关节镜检查后的结果

背景：

运动员大师 (MA) 或 40 岁以上的运动员构成了一个患者群体，他们在初次关节镜髋关节手术后的结果在很大程度上是未知的。

目的：

报告初次髋关节镜检查后 MAs 的至少 2 年结果，并将其结果与倾向匹配的非运动员 (NA) 对照组进行比较。

学习规划：

队列研究；证据水平，3。

方法：

在 2008 年 2 月至 2019 年 4 月期间前瞻性收集数据，并对所有接受初次髋关节镜检查的患者进行回顾性审查。如果患者年龄超过 40 岁，并且具有改良 Harris 髋关节评分、非关节炎髋关节评分、髋关节结局评分 - 运动特定子量表和疼痛视觉模拟量表评分的术前数据，则纳入研究。MAs 报告在手术前 1 年内参加了有组织的体育比赛，并且与未报告参加有组织的体育比赛 (NAs) 的对照组患者的倾向相匹配。报告了患者特征、影像学和术中发现、进行的外科手术以及患者报告的结果测量 (PROM)，并在各组之间进行了比较。

结果：

共有 366 髋符合条件；328 (89.6%) 人有足够的随访数据。328 例患者符合纳入标准，但由于倾向评分匹配率的限制，88 例未纳入。其中，80 髋（76 名患者）被归类为 MA（平均年龄 48.9 ± 6.2 岁），并且与 NA 对照组的倾向性匹配为 1:2。各组在基线人口统计学和放射学参数、术中发现和所进行的程序方面具有可比性。MA 的基线和最低 2 年 PROM 得分明显更好（P < .05），满意度更高（P = .01），并且在使用的所有结果工具中实现具有临床意义的改善的比率更高（P< .05)。与 NA 相比，MA 的二次关节镜检查率较低（分别为 0% 和 7.5%；P = .001）和转换为全髋关节置换术的比率（分别为 12.5% 和 26.9%；P = .011）。

结论：

MAs 在初次髋关节镜检查后表现出良好的结果。与倾向评分匹配的 NA 患者对照组相比，MAs 表现出更好的术前和术后 PROM、更高的临床意义改善率、更低的二次关节镜检查率和转换为全髋关节置换术的比率。各组之间 PROM 分数的绝对改善相似。