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2022 AOSSM Annual Meeting Recordings with CME
Elite Female Athletes Demonstrate Greater Improvem ...
Elite Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Rate of Return to Sport Compared to Elite Male Athletes After Hip Arthroscopy: A Sex-Based Comparison in Professional and Collegiate
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Video Transcription
this paper is from my time at the American Hip Institute in Chicago. All of our disclosures are on the AOS website. In terms of a background, considerable research has evaluated outcomes of hip arthroscopy in the male population, but there's been a relative lack of study in female athletes, particularly high-level female athletes. This disparities in Congress with a growing number of female athletes being treated for FIIs with arthroscopic techniques. A few studies have compared outcomes between matched groups of male and female athletes undergoing hip arthroscopy for this treatment. Our purpose was twofold. It was, one, to report minimum two-year PROs and return to sport for elite female athletes undergoing hip arthroscopy for treatment of FIIs, and two, to compare outcomes with a matched control group of elite male athletes. Our hypothesis was that female athletes would demonstrate favorable outcomes and high rates of return to sport at minimum two-year follow-up, and secondarily, that these outcomes would be similar to a matched control group of male athletes. In terms of our methods, we looked at professional collegiate female athletes undergoing primary hip arthroscopy from 2009 to 2018. We looked at minimum two-year PROs. We also looked at return to sport data and rates of achieving various psychometric thresholds. These athletes were then matched to a control group of male athletes for comparison. We ended up with 73 female hips in the study group with an average age of 25.6 and BMI of 25. They were one-to-one matched to 70 control males based on age, BMI, and competition level. Both groups had similar proportion of professional versus collegiate athletes, and it was about an 80-20 split of 80% collegiate, 20% professional. In terms of interoperative findings, female athletes demonstrated less severe labeled hair patterns, ALAD grades, and acetal or Atterbridge grades compared to the matched male control group. In terms of surgical procedures, there are baseline differences between groups in regard to labeled treatment. Female athletes also underwent capsular repair more commonly than male athletes, and male athletes were more likely to undergo femoroplasty and microfracture procedures. In terms of our results, the return to sport rate was similar between groups among those who attempted. It was about 75.4% of the female versus 83.1% in the male. Sixteen female athletes and ten male athletes were unable to return to sport because of hip pain. In terms of our results, interestingly we found that the preoperative scores for the modified Harris hip, the NAHS, NHOSSS, and VAS were lower in the female athletes compared to the male athletes. However, the female athletes did demonstrate significantly greater improvement or a delta value compared to the male athletes in regards to the modified Harris hip score, NAHS, and the VAS. As a result, they demonstrated higher rates of achieving the MCID for NAHS and HOSSS. However, their rates of achieving PASS were similar between the two groups. In terms of our discussion, elite female athletes undergoing primary hyperthroscopy demonstrated significant improvements in PROs from baseline to minimum two-year follow-up. They achieved favorable rates of return to sport in achieving psychometric thresholds. They demonstrated less acetabular chondral injury, were more likely to undergo capsule repair, and were less likely to undergo ephemeroplasty compared to a mass control group of male athletes. Further, female athletes had lower preoperative but similar postoperative scores compared to male athletes for the modified Harris hip, NAHS, HOSSS, and VAS, and also rates of return to sport were similar between the two groups. Lastly, this was likely driven by the lower preoperative scores that female athletes achieved MCID for NAHS and HOSSS at higher rates than the male athletes in the control group. Several limitations of the study that should be noted, one is a retrospective analysis from a single institution. It is a long study period, over nine years, with evolving surgical technique. There is baseline differences between the groups regarding interoperative pathology and surgical treatments. There is also, in elite athletes, a possible ceiling effect of the PROs, particularly the modified Harris hip score in competitive athletes. Additionally, there was a heterogeneous cohort of athletes based off of sport type, as well as level. And then lastly, return to sport was treated as a binary outcome. So in conclusion, elite female athletes undergoing primary hypartheroscopy for FAI demonstrate significant improvement in PRO scores and a high rate of return to sport. Although there was baseline differences between groups, female athletes exhibited greater improvement in PROs and achieved MCID at higher rates compared to a mass control group of male athletes. Thank you very much.
Video Summary
The video discussed a study conducted by the American Hip Institute in Chicago on the outcomes of hip arthroscopy in female athletes. The study aimed to report minimum two-year patient-reported outcomes (PROs) and return to sport rates for elite female athletes undergoing hip arthroscopy for treatment of Femoroacetabular Impingement Syndrome (FAIS). It also aimed to compare the outcomes with a matched control group of male athletes. The study found that female athletes demonstrated significant improvements in PROs and had a high rate of return to sport. They also exhibited greater improvement in PROs compared to the male athletes in the control group.
Asset Caption
Andrew Jimenez, MD
Keywords
hip arthroscopy
female athletes
patient-reported outcomes
return to sport rates
Femoroacetabular Impingement Syndrome
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