Comparing Outcomes of Competitive Athletes Versus Nonathletes Undergoing Hip Arthroscopy for Treatment of Femoroacetabular Impingement Syndrome
Comparing Outcomes of Competitive Athletes Versus Nonathletes Undergoing Hip Arthroscopy for Treatment of Femoroacetabular Impingement Syndrome
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DOI：
10.1177/0363546519885359
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发表时间：
2019-11-19
影响因子：
4.8
通讯作者：
Nho, Shane J.
中科院分区：
文献类型：
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作者：
Clapp, Ian M.;Nwachukwu, Benedict U.;Nho, Shane J.
背景资料：越来越多的研究已经检查了竞技运动员在接受髋关节镜检查治疗股骨髋臼撞击综合征（FAIS）后恢复运动的情况;然而，很少有研究评估这一组中实现有意义的临床结局的比率。目的：确定与接受髋关节镜治疗FAIS的非运动员相比，竞技运动员（专业、半专业或大学生）是否具有更好的2年患者报告结局，并以更高的比率实现最小临床重要差异（MCID）和实质性临床获益。研究设计：队列研究;证据等级3。研究方法：该研究是对所有连续患者的回顾性分析，这些患者被确定为竞技运动员或非运动员，并在2012年1月至2017年4月期间由一名经过奖学金培训的外科医生进行了髋关节镜检查。两组患者按年龄、性别和体重指数1：2匹配。在术前和术后2年收集基线和临床结局，包括髋关节结局评分-日常生活活动、髋关节结局评分-运动子量表（HOS-SS）、改良Harris髋关节评分和国际髋关节结局工具-12，并在两组之间进行比较。分别计算各组的MCID和实质性临床获益，并使用卡方分析进行比较。结果：共有59名竞技运动员和118名非运动员进入最终分析。大部分竞技运动员是足球运动员（23.7%），其次是垒球运动员（10.2%）和跑步运动员（10.2%）。竞技运动员和非运动员之间的术后评分比较显示HOS-SS存在统计学显著差异（平均值+/- SD，84.5 +/- 19.0 vs 76.1 +/- 23.8; P = 0.02）。有意义的结果分析表明，竞技运动员达到MCID HOS-SS阈值的比率更高（97.4% vs 82.5%; P = .021）。两组之间达到任何其他有意义的临床结局阈值的频率没有其他差异。结论：髋关节镜治疗FAIS的竞争性运动员和非运动员产生临床意义的结果在两个病人组。然而，竞技运动员在HOS-SS上达到MCID的比率高于非运动员，并且在术后2年HOS-SS上的评分显著更高。
Background: A growing number of studies have examined return to sport in competitive athletes after undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS); however, few have evaluated the rate of achieving meaningful clinical outcomes in this group. Purpose: To determine if competitive athletes (professional, semiprofessional, or collegiate) have better 2-year patient-reported outcomes and achieve the minimal clinically important difference (MCID) and substantial clinical benefit at higher rates when compared with nonathletes undergoing hip arthroscopy for the treatment of FAIS. Study Design: Cohort study; Level of evidence, 3. Methods: The study was a retrospective analysis of all consecutive patients who identified as either a competitive athlete or a nonathlete and had undergone hip arthroscopy for FAIS by a single fellowship-trained surgeon between January 2012 and April 2017. Patients in the 2 groups were matched 1:2 by age, sex, and body mass index. Baseline and clinical outcomes, including the Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score, and international Hip Outcome Tool-12, were collected preoperatively and at 2 years postoperatively and compared between the groups. The MCID and substantial clinical benefit were calculated for each group separately and compared using chi-square analysis. Results: A total of 59 competitive athletes and 118 nonathletes were included in the final analysis. Most of the competitive athletes were soccer players (23.7%), followed by softball players (10.2%) and runners (10.2%). Postoperative score comparison between competitive athletes and nonathletes demonstrated a statistically significant difference in the HOS-SS (mean +/- SD, 84.5 +/- 19.0 vs 76.1 +/- 23.8; P = .02). Meaningful outcome analysis demonstrated that competitive athletes had a higher rate of achieving the HOS-SS threshold for the MCID (97.4% vs 82.5%; P = .021). There was no other difference in frequency of achieving the threshold for any other meaningful clinical outcome between the groups. Conclusion: Hip arthroscopy for the treatment of FAIS in competitive athletes and nonathletes produced clinically meaningful outcomes in both patient groups. However, competitive athletes achieved the MCID on the HOS-SS at higher rates than nonathletes and had significantly higher scores at 2 years postoperatively on the HOS-SS.