Clinical Outcomes and Return to Sport After Hip Arthroscopy in Ice Hockey Players: Minimum 2-Year Results With Mid- and Long-term Subanalysis

Abstract

Background:

Ice hockey places high demands on the hip, predisposing athletes to femoroacetabular impingement (FAI), although long-term outcomes after hip arthroscopy remain poorly defined.

Purpose:

To evaluate the outcomes and return-to-sport (RTS) rates of ice hockey players undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral pathology at short-, mid-, and long-term follow-up (2, 5, and 10 years), with a secondary subanalysis of RTS durability.

Study Design:

Case series; Level of evidence, 4.

Methods:

Prospectively collected data on ice hockey players who underwent hip arthroscopy between 2008 and 2020 were reviewed. Included patients reported ice hockey participation within 1 year from the surgery and completed preoperative and minimum 2-year postoperative questionnaires for at least 1 of the following patient-reported outcomes (PROs): modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports Specific Subscale (HOS-SSS), International Hip Outcome Tool (iHOT-12), visual analog scale (VAS). Clinically relevant thresholds and secondary procedures were recorded. RTS analysis was based on the number of patients who attempted RTS at 2-, 5-, and 10-year points.

Results:

A total of 72 hockey players were included, with a mean age of 31.3 ± 13.6 years and mean follow-up of 80.2 ± 41.7 months. Significant improvements were observed across all PROs from pre- to postoperative assessments (P < .001). At latest follow-up, thresholds for the minimal clinically important difference were achieved by 74.2% of participants for mHHS, 66.7% for NAHS, 95% for iHOT-12, 68.8% for HOS-SSS, and 76.8% for VAS. On the Patient Acceptable Symptom State anchor question, 86.2% of hockey players responded “yes” at the latest follow-up. Revision arthroscopy was performed in 6 patients (8.3%), and conversion to total hip arthroplasty occurred in 2 patients (2.8%). Of the 61 athletes who attempted RTS, 53 (86.9%) returned to hockey. At 2-year follow-up, 51 of the athletes (83.6%) were still active. At 5-year follow-up, 75.7% continued to play hockey. At 10 years, 57% continued to play. Among the patients who returned to sport, 74.5% returned to play at the same or a higher competitive level.

Conclusion:

Hip arthroscopy for FAIS and labral pathology in hockey players resulted in significant functional improvement and high midterm RTS rates. Importantly, most athletes who returned to play were able to compete at the same or a higher level compared with preoperative status, reinforcing the potential for functional durability of well-performed hip arthroscopy in this athletic cohort.