Summary

Master athletes, or athletes over the age of 40, demonstrated favorable outcomes after primary hip arthroscopy at five-year minimum follow-up.

Abstract

Purpose

Master athletes (MAs), or athletes over the age of 40, make up a patient population whose midterm outcomes after primary arthroscopic hip surgery are largely unstudied. The purpose of this study is to report minimum five-year outcomes of MAs after primary hip arthroscopy and compare their results to a propensity-matched nonathlete (NA) control group.

Methods

Data was collected between February 2008 and April 2019 and reviewed for all patients who underwent primary hip arthroscopy. Patients were excluded if they were under the age of 40, had previous ipsilateral hip pathology, dysplasia (LCEA < 18°), Tonnis grade > 1, or workers compensation claims. Patients included in the MA cohort reported participation in sports within 1 year before surgery and had five-year minimum follow-up. MAs were matched to NAs in a 1:1 ratio based on age, sex, BMI, and Acetabular Outerbridge Grade. Patient characteristics, radiographic measurements, intraoperative findings, surgical procedures performed, and PROs were compared between the groups. Additionally, rates of meeting clinically relevant thresholds and secondary procedures were compared.

Results

A total of 118 hips were included in the study, with 59 hips per group. The groups showed comparable demographics, intraoperative findings, and labral procedures. The MA group had higher preoperative and postoperative scores for mHHS, NAHS, and HOS-SSS (p < 0.05). MAs met PASS and MOI for all evaluated PROs at higher rates. Additionally, the study group met MCID for mHHS and HOS-SSS at higher rates when compared to the control group (p < 0.05). MAs underwent secondary arthroscopy at similar rates when compared with NAs (1.59% vs. 5.08%; p > 0.05) and had higher arthroplasty-free survivorship (94.92% vs. 71.19%, p < 0.01).

Conclusion

MAs demonstrated favorable outcomes after primary hip arthroscopy at five-year minimum follow-up. When compared with a matched control group of NA patients, MAs had better preoperative and postoperative PROs scores. Furthermore, MAs met clinically meaningful thresholds at higher rates and had higher arthroplasty-free survivorship when compared to the NA group.