Susan Y. Kwiecien, Milan P. Mueller, John J. Grossi, Timothy F. Tyler, Malachy P. McHugh, FACSM, Gregory J. Galano.
Nicholas Institute of Sports Medicine and Athletic Trauma, New York, NY. (Sponsor: Malachy McHugh, FACSM)
Abstract
PURPOSE: Femoroacetabular impingement (FAI) is increasingly recognized as a cause for hip and groin pain in young, active patients. When symptomatic FAI limits performance and nonoperative measures fail, surgery is necessary. Recovery durations and successful return to sport (RTS) rates vary, with current guidelines recommending RTS at 9 months post-surgery. This study aimed to assess the time to RTS following hip arthroscopy for FAI syndrome. The purpose was to assess if individuals safely RTS sooner than 9 months.
METHODS: Patients undergoing hip arthroscopy for FAI performed by one surgeon were retrospectively contacted. The surgeon prescribed an accelerated rehabilitation protocol, emphasizing early low-impact exercise and rapid progression of weightbearing, range of motion, and strength training. A Modified Harris Hip Score (HHS) and Copenhagen Hip and Groin Outcome Score (HAGOS) were administered at 26±11 months following surgery. Pre- and post-injury activity level, time to RTS, complications and revision surgeries were recorded.
RESULTS: This cohort comprised 57 athletes (35 females, 22 males, 38.0±13.9 years old, 31 recreational and 26 competitive-level athletes). 45 patients RTS at or above pre-injury levels (Figure 1), with a majority (55.6%) of patients returning to sport in <6 months. Of the 12 patients that did not RTS, 5 (41.7%) did not return for reasons other than their hip. The mean HAGOS of those able to RTS (65.6) was significantly more than for those who did not (54.0; p=0.027). The mean Modified HHS for those returning to sport (89.4) was greater than those who did not (81.9; p=0.143).
CONCLUSIONS: This study provides evidence that rapid, progressive rehabilitation following hip arthroscopy for FAI is a reliable approach for facilitating athletes’ RTS without increased risks.
