American Hip Institute Research Foundation, Chicago, Illinois, USA.
AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA.
Am J Sports Med. 2022 Jan;50(1):68-78. doi: 10.1177/03635465211056964. Epub 2021 Nov 22.
Patient-reported outcomes (PROs) and return to sports (RTS) after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) have not been established in elite athletes with coexisting low back pain (LBP).
(1) To report minimum 2-year PROs and RTS rates after primary hip arthroscopy for FAIS in elite athletes with coexisting LBP and (2) to compare clinical results with a propensity-matched control group of elite athletes without back pain.
Cohort study; Level of evidence, 3.
Data were reviewed for elite athletes (college and professional) who underwent hip arthroscopy for FAIS and had coexisting LBP between October 2009 and October 2018. Inclusion criteria were preoperative and minimum 2-year follow-up for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale for pain. Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle <18°), and previous ipsilateral hip or spine surgery or conditions. Rates of achieving the minimal clinically importance difference (MCID), patient acceptable symptomatic state (PASS), and maximum outcome improvement satisfaction threshold were recorded in addition to RTS. For the subanalysis, the elite athlete study group was propensity matched to an elite athlete control group without back pain.
A total of 48 elite athletes with LBP who underwent primary hip arthroscopy met inclusion criteria, and follow-up was available for 42 (87.5%) at 53.2 ± 31.6 months (mean ± SD). Elite athletes with coexisting LBP demonstrated significant improvements in all recorded PROs and achieved the MCID and PASS for the HOS-SSS at rates of 82.5% and 67.5%, respectively. They also returned to sports at a high rate (75.8%), and 79% of them did not report LBP postoperatively. PROs, rates of achieving the MCID and PASS for the HOS-SSS, and RTS rates were similar between the study group and propensity-matched control group.
Elite athletes with coexisting LBP who undergo primary hip arthroscopy for FAIS may expect favorable PROs, rates of achieving the MCID and PASS for the HOS-SSS, and RTS rates at minimum 2-year follow-up. These results were comparable to those of a propensity-matched control group of elite athletes without back pain. In athletes with hip-spine syndrome, successful treatment of their hip pathology may help resolve their back pain.
患有髋关节撞击综合征（FAIS）合并腰痛（LBP）的精英运动员，其髋关节镜术后患者报告结局（PROs）和重返运动（RTS）情况尚未明确。
（1）报告合并 LBP 的 FAIS 精英运动员行初次髋关节镜术后至少 2 年的 PROs 和 RTS 率；（2）并与无腰痛的匹配精英运动员对照组的临床结果进行比较。
队列研究；证据水平，3 级。
回顾 2009 年 10 月至 2018 年 10 月间行髋关节镜治疗 FAIS 且合并 LBP 的精英运动员（大学和职业运动员）的数据。纳入标准为改良 Harris 髋关节评分、非关节炎髋关节评分、髋关节结局评分-运动特异性量表（HOS-SSS）和疼痛视觉模拟评分的术前和至少 2 年随访。排除标准为 Tönnis 分级>1、髋关节发育不良（外侧中心边缘角<18°）、同侧髋关节或脊柱手术史或存在其他疾病。除 RTS 外，还记录了达到最小临床重要差异（MCID）、可接受的症状状态（PASS）和最大结局改善满意度阈值的比率。在亚分析中，将精英运动员研究组与无腰痛的精英运动员对照组进行倾向评分匹配。
共有 48 例合并 LBP 的 FAIS 精英运动员符合纳入标准，42 例（87.5%）获得了 53.2±31.6 个月（均值±标准差）的随访。合并 LBP 的精英运动员的所有记录的 PROs 均有显著改善，HOS-SSS 的 MCID 和 PASS 达标率分别为 82.5%和 67.5%。他们也有较高的重返运动率（75.8%），79%的患者术后无 LBP。研究组和倾向评分匹配对照组的 PROs、HOS-SSS 的 MCID 和 PASS 达标率和 RTS 率相似。
对于 FAIS 合并 LBP 的精英运动员，初次髋关节镜术后至少 2 年随访时，他们可能会获得满意的 PROs、HOS-SSS 的 MCID 和 PASS 达标率和 RTS 率。这些结果与无腰痛的匹配精英运动员对照组相似。在髋关节脊柱综合征患者中，髋关节病变的成功治疗可能有助于缓解其腰痛。
