Ali S Bajwa (MBBS, MRCSEd, MSc Orth, MPhil Cantab, DSEM, MFSEM, FRCS Tr & Orth),
Alexandra Dimitrakopoulou (MD Orthopaedics),
Richard N Villar (MBBS, MA, MS, FRCS)
The Villar Bajwa Practice, Cambridge & London, UK.
The purpose of this study was to investigate the return to sport at six months following hip arthroscopy among professional footballers and the factors influencing it.
Methodology
Study design: Prospective cohort.
Inclusion criteria: Consecutive patients, professional footballers, hip pathology diagnosis, decision to proceed with surgery.
Exclusion criteria: Patients treated without hip arthroscopy.
Intervention: Hip arthroscopy.
Principal outcome: Return to sport at six months.
Secondary outcomes: Non-Arthritic Hip Score (NAHS), Visual Analogue Scale (VAS) for satisfaction.
Statistics: Student t-test, chi squared test, descriptive (Microsoft Excel).
Intervention
The prospective cohort of 29 male professional footballers who underwent hip arthroscopy had following interventions:
- Labral repair / partial labrectomy: 22 / 29 (75.8%)
- Chondral repair / microfracture: 20 /29 (68.9%)
- Shrinkage of Ligamentum Teres: 2 / 29 (6.8 %)
- Excision of FAI lesion: 22 / 29 (75.8 %)
- Iliopsoas release: 3 / 29 (10.8 %)
- Removal of loose body: 4 / 29 (13.7 %)
Results
Mean age: 29 years (SD 6.4).
At six months return to sport: 23 / 29 (79.3 %).
Mean improvement 14.6 points on NAHS (p < 0.05).
NAHS
VAS (satisfaction)
Pre-op
71.1 (SD 13.2)
N/A
Post-op
85.7 (SD 15.3)
83 (SD 16.1)
Fig. 1: 26-year old professional footballer with significant chondral damage secondary to cam FAI.
Fig. 2: Exposure of anterior acetabular rim in a footballer with mixed impingement.
Discussion
A total of 6 athletes out of 29 did not return to sport at six-month post-operatively.
Poor prognostic factors
- Higher grade of chondral damage, ICRS grade ≥ 3 (p < 0.05).
- Increasing age at the time of surgery (p < 0.05).
- Not related to specific type of arthroscopic intervention, dominance of limb or the operating time.
Acknowledgement
Mihir Paikray (Data management & IT Support)
Dr Kay Brennan (Patient follow-up reviews)
Correspondence
Ali Bajwa: alibajwa@villarbajwa.com
www.villarbajwa.com