Do Professional Athletes Perform Better Than Recreational Athletes After Arthroscopy for Femoroacetabular Impingement?
BACKGROUND: Although a large number of athletes' returns to sports after hip arthroscopic surgery for femoroacetabular impingement (FAI), it is not clear if they do so to the preinjury level and whether professional athletes (PA) are more likely to return to the preinjury level compared with recreational athletes (RA). QUESTIONS/PURPOSES: We therefore compared (1) the time taken to return to the preinjury level of sport between professional and recreational athletes; (2) the degree of improvement in time spent in training and competitive activities after arthroscopic surgery for FAI; and (3) the difference in trend of improvement in hip scores. METHODS: We prospectively followed 80 athletes (PA = 40, RA = 40; mean age, 35.7 years; males = 50, females = 30; mean followup, 1.4 years; range, 1-1.8 years) who underwent hip arthroscopy for FAI. We measured the time to return to sports; training time and time in competition; and the modified Harris hip score and the nonarthritic hip score. RESULTS: There was a 2.6-fold improvement in the training time (from 7.8 to 20 hours per week) and a 3.2-fold increase in time in competition (from 2.5 to 7.9 hours per week) 1 year after surgery. The mean time to return to sporting activities was 5.4 months, which was lower for PA (4.2) as compared with RA (6.8). Eighty-two percent (66) (PA = 88%  versus RA = 73% ) returned to their preinjury level of sport within 1 year of surgery. CONCLUSIONS: The data suggest PA may show quicker return to sports than RA but the hip scores and rate of return to sports are similar. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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ABSTRACT: Hip disorders are increasingly recognized as a cause of dysfunction and disability among athletes. Femoroacetabular impingement (FAI) is a common source of hip problems. While FAI may sometimes be present as an incidental asymptomatic finding, substantial secondary joint damage may occur. This problem is often observed in young adult, and even adolescent, athletes. FAI morphology results in a breakdown of the labrum and articular surfaces from forces generated during sporting activities that would otherwise be well tolerated by a normal joint. A description of the pathomechanics is included. Detection of pathological FAI is important to minimize its harmful effects. The history, examination findings, and pertinent imaging studies are detailed. Nonoperative measures, including training modifications and pelvic stabilization exercises, may be of some benefit in modulating symptoms. When secondary joint damage has occurred, surgical intervention is usually necessary. While most can be managed with arthroscopic techniques, open and mini-open methods are discussed as well. With proper recognition and treatment, most athletes can expect to return to sports, although the long-term implications of high-level activities must still be considered. These results are summarized.
Available from: Danyal H Nawabi
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The purpose of this study was to determine differences in age, gender, and the need for bilateral surgery between high-level athletes grouped by sports with similar mechanical demands on the hip and recreational athletes undergoing hip arthroscopy for femoroacetabular impingement (FAI).
By use of a hip-preservation center registry, a retrospective review of patients undergoing hip arthroscopy for FAI between March 2010 and April 2012 was performed. Athletes were categorized as high level (high school, collegiate, or professional) or recreational. We performed a subgroup analysis for high-level athletes, looking at differences among contact, cutting, impingement, overhead/asymmetric, endurance, and flexibility sports.
The study included 288 high-level athletes and 334 recreational athletes. Being a high-level athlete was associated with a younger age (mean age, 20.2 years v 33.0 years; odds ratio, 0.69; P < .001) and male gender (61.5% v 53.6%; odds ratio, 1.75; P = .03). The percentage of high-level athletes undergoing bilateral surgery was higher than that of recreational athletes (28.4% v 15.9%); however, this association was found to be confounded by age on multivariate analysis. The most common sports for high-level athletes were soccer, hockey, and football. Athletes participating in cutting sports were significantly younger than athletes participating flexibility, contact, or impingement sports.
When compared with recreational athletes undergoing arthroscopic treatment for FAI, high-level athletes are more likely to be younger, to be male, and to undergo bilateral surgery. When high-level athletes are grouped by the mechanical demands placed on the hip by their sport, athletes participating in cutting sports are more likely to be younger than those in the other groups.
Level of Evidence
Level IV, case series.
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