BoulderCentre for Orthopedics, Boulder, Colorado, U.S.A.
Department of Orthopedics, University of Illinois at Chicago, Chicago, Illinois, U.S.A.
Arthroscopy. 2019 Oct;35(10):2834-2844. doi: 10.1016/j.arthro.2019.04.029.
To present minimum 2-year patient-reported outcomes (PROs) and return to sport (RTS) data for a population of basketball players after hip arthroscopy.
Data were prospectively collected and retrospectively reviewed for all patients who underwent hip arthroscopy between February 2009 and May 2014. Patients with preoperative and minimum 2-year postoperative PROs, visual analog scale score for pain, and satisfaction, who regularly played basketball within 1 year before surgery, and who attempted to RTS met the inclusion criteria. Exclusion criteria were previous ipsilateral hip surgery or conditions such as fracture, dysplasia, or femoral avascular necrosis. Patients were matched 1:1 to a control group composed of those who did not play any sports before surgery, based on the following matching criteria: age ±5 years, sex, and body mass index ±5. Statistical analysis was performed to determine significant differences in PROs. Conversion to total hip arthroplasty (THA) was considered an endpoint.
Thirty-one patients (81.6%) met inclusion criteria with follow-up of 46.8 ± 20.6 months. The mean age was 30.0 ± 12.3, and the mean body mass index was 26.3 ± 6.5. Male patients (64.5%) outnumbered female patients (35.5%). A majority of the players (54.8%) identified themselves as recreational athletes; the remainder competed at the high school, collegiate, amateur, or professional level. There was significant (P < .001) improvement in all PRO measures and visual-analog scale scores from baseline to a minimum 2-year follow-up. At the most recent follow-up, mean patient satisfaction was 8.1 ± 2.1. Twenty-two (78.6%), and 23 patients (82.1%) achieved the patient acceptable symptom state on the modified Harris Hip Score and the Hip Outcomes Score-Sports Specific Subscale. Twenty-one (75.0%) and 17 (60.7%) patients had a minimal clinically important difference on the modified Harris Hip Score and the Hip Outcomes Score-Sports Specific Subscale, respectively. Three patients (9.7%) with an average age of 47.5 (P = .023) converted to THA at a mean of 35.9 ± 7.2 (range 29.66-43.75) months after arthroscopy. At the most recent follow-up, the RTS rate was 83.9%. Subjective ability level was the same or higher in 23 patients (74.2%).
Hip arthroscopy in basketball athletes demonstrates a significant increase in PROs, a high RTS rate, and a low risk of complications. Hip arthroscopy may be considered in basketball players <40 years old for whom nonoperative treatment fails and who have a significantly limited level of play. Careful patient selection and counseling should be used when considering hip arthroscopy in basketball players >40 years old because there may be a high rate of conversion to THA.
Level III, retrospective comparative study.
介绍一组接受髋关节镜手术的篮球运动员的至少 2 年患者报告结局（PROs）和重返运动（RTS）数据。
对 2009 年 2 月至 2014 年 5 月期间接受髋关节镜手术的所有患者进行前瞻性数据收集和回顾性研究。符合纳入标准的患者为术前和至少 2 年术后 PROs、疼痛视觉模拟评分和满意度均有记录，术前 1 年内经常打篮球，且试图 RTS。排除标准为同侧髋关节手术史或骨折、发育不良或股骨缺血性坏死等疾病。根据以下匹配标准，将患者与术前不参加任何运动的对照组进行 1:1 匹配：年龄±5 岁、性别和体重指数±5。采用统计学分析比较 PROs 的差异。将全髋关节置换术（THA）转换视为终点。
31 名患者（81.6%）符合纳入标准，随访时间为 46.8±20.6 个月。平均年龄为 30.0±12.3 岁，平均体重指数为 26.3±6.5。男性患者（64.5%）多于女性患者（35.5%）。大多数运动员（54.8%）为娱乐运动员；其余的运动员在高中、大学、业余或职业水平上竞争。所有 PRO 测量和视觉模拟评分均从基线显著改善（P<0.001）至至少 2 年的随访。在最近的随访中，平均患者满意度为 8.1±2.1。22 名（78.6%）和 23 名（82.1%）患者在改良 Harris 髋关节评分和髋关节结局评分-运动特异性亚量表上达到患者可接受的症状状态。21 名（75.0%）和 17 名（60.7%）患者在改良 Harris 髋关节评分和髋关节结局评分-运动特异性亚量表上有最小临床重要差异。3 名（9.7%）平均年龄为 47.5（P=0.023）的患者在关节镜术后平均 35.9±7.2（范围 29.66-43.75）个月时转换为 THA。在最近的随访中，RTS 率为 83.9%。23 名患者（74.2%）的主观能力水平相同或更高。
在篮球运动员中，髋关节镜手术可显著提高 PROs，RTS 率高，并发症风险低。对于非手术治疗失败且运动水平明显受限的<40 岁的篮球运动员，可考虑髋关节镜手术。对于>40 岁的篮球运动员，在考虑髋关节镜手术时应谨慎选择患者并进行咨询，因为可能会有较高的 THA 转化率。
III 级，回顾性比较研究。
