Return to Sport After Hip Arthroscopy With Full-Thickness Acetabular Chondral Defect Treated With Microfracture

Abstract

Background:

Only a few studies have explored return to recreational sport activity after arthroscopic microfracture for full-thickness acetabular lesions.

Hypothesis:

Recreational athletes undergoing acetabular microfracture, in addition to general hip arthroscopy procedures, would not achieve similar sport activity to recreational athletes undergoing hip arthroscopy without microfracture at the 5-year follow-up.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective review was conducted of a prospectively collected multicenter hip arthroscopy database of patients undergoing acetabular microfracture for full-thickness chondral lesions. Inclusion criteria were patients between 18 and 50 years of age who had participated in recreational sports before surgery, a diagnosis of femoroacetabular impingement, arthroscopic microfracture for full-thickness chondral lesion, labral repair, complete clinical patient-reported outcomes (PROs), radiographic measurements, and at least 5 years of postoperative follow-up. For each patient included in the study, 1 patient without chondral damage was paired at a 1:1 ratio based on age and sex. The following were assessed: radiographic evaluation, primary preoperative sport, Tegner activity scale score, self-administered Hip Outcome Score (HOS) questionnaire with Activities of Daily Living Subscale (ADL) and Sports-Specific Subscale (SSS) scores, and self-administered short version of the 12-item International Hip Outcome Tool (iHOT-12) score. Clinical relevance was measured using the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB).

Results:

A total of 33 patients met the inclusion criteria and were matched with 33 patients without chondral damage. There were no patients lost to follow-up. Both groups showed significant improvement from preoperative PROs to 5-year follow-up. There was no difference in the frequency of patients achieving the MCID, PASS, and SCB for PROs. Return to sport at the 5-year follow-up was similar between groups. Sixteen patients (66.7%) in the microfracture group changed the type of sport they participated in, compared with 9 patients (34.6%) in control group; this difference was statistically significant. The Tegner activity scale score decreased significantly in both groups, but there was no difference between them.

Conclusion:

Recreational athletes with full-thickness chondral lesions treated with arthroscopy acetabular microfracture experienced similar return to play to recreational athletes without chondral lesions at the 5-year follow-up. However, a statistically significantly higher rate of athletes in the microfracture group changed the type of sport they participated in.