Favorable Patient-Reported Outcomes and High Return to Sport Rates Following Hip Arthroscopy in Adolescent Athletes: A Systematic Review

Emily Arciero; Rafael Kakazu; Patrick Garvin; Allison E Crepeau; Katherine Coyner

doi:10.1016/j.arthro.2022.02.022

Favorable Patient-Reported Outcomes and High Return to Sport Rates Following Hip Arthroscopy in Adolescent Athletes: A Systematic Review

Arthroscopy. 2022 Sep;38(9):2730-2740. doi: 10.1016/j.arthro.2022.02.022. Epub 2022 Mar 2.

Authors

Emily Arciero¹, Rafael Kakazu², Patrick Garvin², Allison E Crepeau³, Katherine Coyner⁴

Affiliations

¹ University of Connecticut School of Medicine, Farmington Connecticut, U.S.A.
² Department of Orthopaedic Surgery, University of Connecticut, Farmington Connecticut, U.S.A.
³ Department of Orthopaedic Surgery, University of Connecticut, Farmington Connecticut, U.S.A; Connecticut Children's Sports Medicine, Farmington Connecticut, U.S.A.
⁴ Department of Orthopaedic Surgery, University of Connecticut, Farmington Connecticut, U.S.A. Electronic address: coyner@uchc.edu.

PMID: 35247510
DOI: 10.1016/j.arthro.2022.02.022

Abstract

Purpose: The purpose of this systematic review is to synthesize the existing literature surrounding hip arthroscopy in the adolescent athlete population to determine patient-reported outcomes, return to sport rates, complications, and reoperations associated with this intervention.

Methods: A systematic literature review was performed using PubMed (MEDLINE), Cochrane Library, and Embase according to PRISMA guidelines. Studies were included if they were published in English with greater than 2 participants, contained patients aged 10-19 years old or classified as "high school athletes" or "middle school athletes," and reported postoperative patient-reported outcomes and return to sport. Patient-reported outcomes (PROs) and their associated P values were recorded. Finally, return-to-sport outcomes and sports played were also extracted from the included studies. Weighted kappa was used to assess inter-reviewer agreement.

Results: Eleven studies included in the final analysis, resulting in 344 patients and 408 hips were analyzed by this review. Patient-reported outcomes (PROs) were reported in all studies. The modified Harris Hip Score (mHHS) was used in all but 1 study. Six of the 11 studies reported a 100% return-to-sport rate, for a total of 98/98 athletes returning to sport. Fabricant et al. did note that a majority of athletes who returned to sport were able to do so at a subjective "nearly normal" level. Only 4 of the studies reported complications, with the majority being transient neuropraxias.

Conclusions: Adolescent athletes who undergo hip arthroscopy demonstrate favorable postoperative patient-reported outcome scores, high rates of return to sport, and an overall low complication rate. The heterogeneity in both surgical methodology and outcome measures used for evaluation and treatment leads to continued ambiguity with regard to the optimal method for managing adolescent athletes with hip pathology.

Level of evidence: V, systematic review of Level II-V studies.

Keywords: adolescent athlete; femoroacetabular impingement; hip arthroscopy; patient-reported outcomes; return to sport.

Publication types

Review
Systematic Review

MeSH terms

Adolescent
Adult
Arthroscopy* / methods
Athletes
Child
Femoracetabular Impingement* / surgery
Follow-Up Studies
Hip Joint / surgery
Humans
Patient Reported Outcome Measures
Retrospective Studies
Return to Sport
Treatment Outcome
Young Adult