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AOSSM 2022 Annual Meeting Recordings - no CME
Comparing Midterm Outcomes of High-Level Athletes ...
Comparing Midterm Outcomes of High-Level Athletes Versus Nonathletes Undergoing Primary Hip Arthroscopy: A Propensity Matched Comparison with Minimum 5-year Follow-Up
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Video Transcription
Good afternoon, everybody. Thank you for the opportunity representing the following study by my colleagues. These are our institution disclosures. So to start, hypertroscopy for the treatment for FAI has been proven to be a reliable treatment in high-level athletes and demonstrated favorable outcomes. When compared to the general population, high-level athletes have been shown to have better short-term outcomes after undergoing hypertroscopy. But the durability of superior outcomes in high-level athletes undergoing hypertroscopy has not been established with mid-term follow-up yet. Therefore, the purpose of the study is to report mid-term outcomes of high-level athletes undergoing primary hypertroscopy for FAI and also to compare outcomes with a match control group of non-athletes. We have hypothesized that high-level athletes will demonstrate favorable outcomes at mid-term follow-up and also these outcomes will be superior to a match control group of non-athletes. So for choosing our population, we chose professional college and high school athletes undergoing primary hypertroscopy for FAI from institution's database from 2005 to 2015. And they were eligible if they had a minimum two-year and five-year PROs for Modified High-Risk Hip Score, Non-Arthritic Hip Score, and HOSSS. Also a return to sports data and rates of achieving MCAD and PASS were evaluated in our patients and these athletes were matched to a control group of non-athletes for comparison. After our eligibility process, we were left with 77 hips in the study group, a mean age of 23.9 years, and with a follow-up of 74.6 months. They were then matched one-to-one by age, sex, and BMI. And the follow-up with both groups was similar, 74.6 months versus 79.5 months. So we found that soccer and football were the most popular sports. As we can see in our pie chart, there were considerable variability in the sports plays by our population. We found that most athletes participated in the sports at the high school level in the study with a 40.3 percent, college athletes of 26.9 percent, and professional athletes of 32.8 percent. Due to the nature of propensity matching, the radiographic measurements, intraoperative findings, and surgical procedures performed were similar between both of the groups. Now in regards of the PROs, we found that preoperative scores for the Modified High-Risk Hip Scores and Non-Arthritic Hip Scores were higher for the athlete groups, but they were not different for the HOSSS. But both groups had similar two-year and five-year postoperative scores for all of the PROs. In regards of MCAD and PASS, the rates of achieving MCAD and PASS were similar between groups for the Modified High-Risk Hip Scores and HOSSS. And even though athletes demonstrated higher rates of achieving PASS for the HOSSS at a five-year follow-up, this did not reach its significant significance being of a p-value of 0.070. Also we found that the rates of revision surgery were similar between both of the groups of athletes and non-athletes. So the findings, the main findings in this study are that high-level athletes demonstrated favorable outcomes and achieved psychometric thresholds at acceptable rates at minimum five-year follow-up. We also found that athletes demonstrated higher preoperative scores for Modified High-Risk Hip Scores and Non-Arthritic Hip Scores compared to non-athletes. But these results were ultimately similar to the ones of the CONTROLS groups at two and five-year follow-up. In regards to the previously demonstrated superior outcomes in athletes undergoing hypartheroscopy, interestingly were not found in the present study. Of course our study does not come without limitations. It is a retrospective analysis from a single institution and our study was performed over a long period of time of seven years, which means as we know in the realm of hip arthroscopy, the surgical techniques are in constant evolution. Also all athletes were considered equal despite the wide range of competition levels from high school all the way to professional level. Some of the patients in an athlete cohort may not have been still participating in sports at our five-year follow-up. So we can conclude that primary hip arthroscopy resulted in favorable mid-term outcomes in high-level athletes. And when we compare them to a propensity-matched non-athletic CONTROL group, we found that the athlete group demonstrated a tendency toward higher rates of achieving a pass for HOSSS, but had similar post-operative outcomes and similar arthroscopic revision rates at minimum five-year follow-up. We can say that superior short-term outcomes found in athletes compared to non-athletes in the literature may not be durable at mid-term follow-up as we can see in our present study. Thank you so much for the opportunity.
Video Summary
The study discussed in the video focuses on the mid-term outcomes of high-level athletes undergoing primary hip arthroscopy for femoroacetabular impingement (FAI). The researchers hypothesized that athletes would have favorable outcomes compared to a control group of non-athletes. They analyzed data from 77 hips in the athlete group and matched them with non-athletes based on age, sex, and BMI. The results showed that athletes had higher preoperative scores but similar postoperative scores for hip scores. The rates of achieving PASS for the HOSSS were slightly higher in athletes but not significant. The study suggests that superior short-term outcomes in athletes may not be durable in the mid-term.
Asset Caption
Paulo Padilla, MD
Keywords
study
mid-term outcomes
high-level athletes
hip arthroscopy
femoroacetabular impingement
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