Summary

This study reports on minimum 5-year patient-reported outcomes (PROs) and return to sport (RTS) rates in high-level athletes with borderline hip dysplasia (BHD) following primary hip arthroscopy for labral pathology and femoroacetabular impingement syndrome (FAIS).

Abstract

The purpose is to report minimum 5-year patient-reported outcomes (PROs) and return to
sport (RTS) rates in high-level athletes with borderline hip dysplasia (BHD) following
primary hip arthroscopy for labral pathology and femoroacetabular impingement
syndrome (FAIS) and to compare results to a propensity-matched control group of
athletes with normal acetabular coverage.

Methods

Data were reviewed for surgeries performed between February 2009 and February 2016. Patients were eligible if they underwent primary hip arthroscopy in the setting of BHD [LCEA 18-25°] and competed in professional, collegiate, or high school sports. Inclusion criteria were preoperative and minimum 5-year follow-up scores for the modified Harris Hip Score (mHHS), Non-arthritis Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and Visual Analog Scale (VAS) for pain. Rates of achieving the minimal clinically importance difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold (MOIST) were recorded in addition to RTS. BHD athletes were matched by age at the time of surgery, sex, BMI, Tönnis grade, follow-up time, sport type, and competition level to a control group of 58 athletes with normal acetabular coverage (LCEA 25°- 40°).

Results

A total of 34 BHD athletes were included with a mean follow-up of 73.6 ± 10.7
months. BHD athletes showed significant improvements in all PROs, demonstrated
high RTS rates (90.0%), and achieved PASS/MCID/MOIST for mHHS (MCID: 80.0%,
PASS: 93.3%, MOIST: 80.0%) and HOS-SSS (MCID: 76.7%, PASS: 73.3%) at high
rates. When compared to a propensity-matched group with normal acetabular
coverage, BHD athletes demonstrated similar postoperative PROs, rates of achieving
psychometric thresholds, and RTS rates (P > 0.05).

Conclusion

High-level athletes with BHD undergoing primary hip arthroscopy for labral
pathology and femoroacetabular impingement syndrome may expect favorable midterm outcomes and high RTS rates. These results were comparable to a control group
of athletes with normal coverage.