Return to Long-Distance Running After Hip Arthroscopy for Femoroacetabular Impingement

Abstract

Background:

Arthroscopic hip surgery for femoroacetabular impingement syndrome (FAIS) has high rates of return to sport; however, patient return to long-distance running is unclear.

Hypotheses:

(1) Long-distance runners undergoing arthroscopic hip surgery for FAIS are a distinctive subgroup in terms of demographics, hip injury characteristics, and running metrics. (2) Most patients will return to general running but a lower proportion return to long-distance running after arthroscopic hip surgery.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

An institutional hip preservation registry was reviewed retrospectively for long-distance runners (half marathons, marathons) who underwent primary hip arthroscopies for FAIS between March 2008 and January 2018. Patient demographics, injury characteristics, and clinical and radiographic findings were recorded. Multivariable logistic regression analysis identified potential risk factors for not returning to long-distance running.

Results:

Sixty-eight (78 hips) long-distance runners (mean patient age, 37.8 ± 8.9 years; 38 (56%) female; mean weekly running mileage before injury, 34.5 ± 16.9 miles) were included. Overall, 50 runners (74%) returned to any running, of which 25 (50%) returned to long-distance running, completing half/full marathons races after surgery. Most common reasons for not returning to running were pain or discomfort (50%) followed by fear of reinjury (22%), and additional different injuries (22%). Multivariable logistic regression analysis revealed female runners (odds ratio, 0.2; CI, 0.0-0.9; P = 0.03) were less likely to return to long-distance running.

Conclusion:

Most (74%) long distance runners returned to running after hip arthroscopic treatment for FAIS; however, only 37% returned to long-distance running. Satisfaction from surgery was not necessarily associated with return to running. Female long-distance runners were less likely to return to long-distance running after surgery.

Clinical Relevance:

Study findings provide helpful context for clinicians counseling patients with symptomatic FAIS who are considering hip arthroscopy and are concerned about return to long-distance running.