ISAKOS Congress 2021

2021 ISAKOS Biennial Congress Paper

 

Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Return To Sport Rates Compared to Males After Hip Arthroscopy A Gender Based Matched Comparison of High-Level Athletes

Andrew Jimenez, MD, Chicago, Illinois UNITED STATES
Rachel Glein, BS, Des Plaines, Illinois UNITED STATES
Kara Miecznikowski, BS, Des Plaines, IL UNITED STATES
Benjamin Saks, MD, Des Plaines, IL UNITED STATES
Hari Krishna Ankem, MD, Chicago, ILLINOIS UNITED STATES
Payam William Sabetian, MD, Chicago, IL UNITED STATES
Benjamin G. Domb, MD, Des Plaines, IL UNITED STATES

American Hip Institute Research Foundation, Des Plaines, Illinois, UNITED STATES

FDA Status Cleared

Summary

Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Return To Sport Rates Compared to Males

Abstract

Background

No studies have compared outcomes or return to sport between a matched cohort of male and female athletes with minimum 2-year follow-up.

Purpose

(1) To report minimum 2-year patient reported outcome scores (PROs) and return to sport for high-level female athletes undergoing hip arthroscopy for femoroacetabular impingement (FAI) and (2) to compare clinical results with a matched control group of high-level male athletes.

Study Design: Cohort study; Level of evidence, 3.

Methods

Data on all high-level female athletes who underwent primary hip arthroscopy between March 2009 and July 2018. Patients were considered eligible if they underwent hip arthroscopy for FAI and participated in high school, collegiate, or professional athletics. Minimum 2-year PROs were collected for the modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), visual analog scale (VAS) for pain, and return to sport (RTS) status. The percentage of patients achieving minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for the mHHS, NAHS, and HOS-SSS were also recorded. These patients were propensity score matched in a 1:1 ratio to male high-level athletes undergoing primary hip arthroscopy for FAI.

Results

Seventy-three high-level female athletes were included with a mean follow-up of 65.1 ± 27.9 months. They demonstrated significant improvement from preoperative to latest follow-up for mHHS, NAHS, HOS-SSS, and VAS (P < .05). The rate of return to sport was 75.4%, and patients achieved PASS/MCID for mHHS, HOS-SSS, and NAHS at high rates. Female athletes received a greater percentage of capsular repair and iliopsoas fractional lengthening compared to male athletes (P < .001). When outcomes were compared to a propensity matched control group of male athletes, female athletes demonstrated significantly better magnitude of improvement (delta value) for mHHS, NAHS, and VAS (P < .05). Female athletes also achieved MCID for HOS-SSS and NAHS at higher rates than male athletes (P < .05). There was no difference in RTS rates between the two groups (P > .05).

Conclusion

High-level female athletes undergoing primary hip arthroscopy for FAI demonstrate significant improvement in PROs and high rates of return to play. Female athletes exhibit greater improvement in PROs (mHHS, NAHS, VAS) and achieve MCID (HOS-SSS, NAHS) at higher rates when compared to a matched group of male athletes.

International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine

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