Background:

Bilateral hip symptoms are common in athletes, and athletes may require treatment with bilateral hip arthroscopy. Return-to-sport (RTS) rates in competitive athletes after unilateral procedures have been reported at 74% to 93%; however, RTS rates after bilateral hip arthroscopy are still unknown.

Purpose/Hypothesis:

The purpose was to determine rate of RTS in competitive athletes undergoing bilateral hip arthroscopy and report minimum 1-year patient-reported outcomes (PROs) for this cohort. We hypothesized that after bilateral hip arthroscopy, the RTS rate would be similar to the square of the probability of returning after unilateral hip arthroscopy.

Study Design:

Case series; Level of evidence, 4.

Methods:

Data were prospectively collected on patients undergoing hip arthroscopy at our institution from November 2011 to July 2018. Patients were included if they underwent bilateral hip arthroscopy and were a high school, collegiate, or professional athlete before their first surgery. A patient’s RTS was defined as return to competitive participation in one’s sport at a level the same as or higher than the preoperative level. Additionally, minimum 1-year PROs, including modified Harris Hip Score (mHHS), nonarthritic hip score, and Hip Outcome Score–Sports Specific Subscale (HOS-SSS), as well as complication rates and future surgery were compared for all patients. Rates of reaching the minimal clinically importance difference (MCID) and patient acceptable symptomatic state (PASS) for the mHHS (8 and 74, respectively) and HOS-SSS (6 and 75, respectively) were also recorded.

Results:

A total of 87 patients met inclusion criteria, for which follow-up was available for 82 (94.3%). At latest follow-up, 100% of professional athletes had returned to their sport, while 53.7% of the entire cohort returned to their sport, with 75.8% of male patients returning versus 38.8% of female patients (P < .001). Of patients returning, 56% did so at the same ability or higher. The most common reason for not returning was graduation or lifestyle change (47.4%). Patients returning to sport had significantly higher PROs at latest follow-up relative to those who did not return, including mHHS (93.7 vs 87.5), nonarthritic hip score (94.4 vs 88.2), and HOS-SSS (90.9 vs 78.2) (P < .05). Rates of achieving the PASS and MCID for the mHHS were not significantly different. However, for the HOS-SSS, patients who returned had significantly higher rates of achieving the MCID and PASS thresholds.

Conclusion:

The rate of RTS among competitive athletes after bilateral hip arthroscopy was similar to the square of published RTS rates after unilateral hip arthroscopy. Both those who returned to play and those who did not showed significant improvement in PROs after surgery. However, those who returned to sports achieved significantly higher scores in all outcome measures. Additionally, patients returning to sports showed a significantly higher rate of attaining the MCID and PASS scores for the HOS-SSS.

中文翻译：

---

高水平运动员双侧髋关节镜检查后运动和功能结局的恢复率。

背景：

双侧髋关节症状在运动员中很常见，并且运动员可能需要使用双侧髋关节镜进行治疗。据报告，单方面程序后竞技运动员的返程率（RTS）为74％至93％；然而，双侧髋关节镜检查后的RTS率仍然未知。

目的/假设：

目的是确定接受双侧髋关节镜检查的竞技运动员的RTS率，并报告该队列的至少1年患者报告的结局（PRO）。我们假设在双侧髋关节镜检查后，RTS率类似于单侧髋关节镜检查后返回概率的平方。

学习规划：

案例系列；证据水平4。

方法：

前瞻性地收集了我们机构从2011年11月至2018年7月接受髋关节镜检查的患者的数据。如果患者接受了双侧髋关节镜检查并且在首次手术前是高中，大学或专业运动员，则将其包括在内。患者的RTS被定义为以与术前相同或更高的水平重新参加一项运动。此外，比较了所有患者的至少1年PRO，包括改良的Harris髋关节评分（mHHS），非关节炎性髋关节评分和髋关节成绩-运动特异性子量表（HOS-SSS），以及并发症发生率和未来手术。对于mHHS（分别为8和74）和HOS​​-SSS（分别为6和75，

结果：

共有87位患者符合入选标准，其中82位（94.3％）可获得随访。在最新的随访中，100％的职业运动员已经恢复了运动，而整个队列中有53.7％的人恢复了运动，其中男性患者的比率为75.8％，女性患者的比率为38.8％（P <0.001）。在返回的患者中，有56％的患者具有相同或更高的能力。不回来的最常见原因是毕业或生活方式的改变（47.4％）。与不返回运动的患者相比，在最近的随访中，重新运动的患者的PROs明显更高，包括mHHS（93.7 vs 87.5），非关节炎性髋关节评分（94.4 vs 88.2）和HOS​​-SSS（90.9 vs 78.2）（P<.05）。mHHS实现PASS和MCID的速率没有显着差异。但是，对于HOS-SSS，返回的患者达到MCID和PASS阈值的比率明显更高。

结论：

双边髋关节镜检查后竞技运动员中RTS的发生率与单侧髋关节镜检查后已发表的RTS率的平方相似。手术后返回比赛的人和PRO均未显示出明显改善的人。但是，那些重返运动的人在所有结局指标中的得分都明显更高。此外，重返运动的患者对HOS-SSS的MCID和PASS得分的获得率明显更高。