Pasurka Mario, Szlufcik Mike, Theodoropoulos John, Betsch Marcel
Department of Orthopaedics and Trauma Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Women's College Hospital, University of Toronto Orthopaedic Sports Medicine Program (UTOSM), Toronto, ON, Canada.
Phys Sportsmed. 2025 Feb;53(1):64-71. doi: 10.1080/00913847.2024.2410148. Epub 2024 Sep 30.
The purpose of this study was to explore currently utilized readiness to Return to Sport (RTS) criteria after Hip Arthroscopy (HA) used in elite athletes to gain novel insights into the RTS decision-making process of professional team physicians. The authors hypothesized that even among this group of highly specialized physicians, there exists variability of measures and criteria used to determine RTS after HA.
A total of 15 qualitative semi-structured interviews with professional team physicians were conducted by a single trained interviewer. The interviews were used to identify team physician concepts and themes regarding the criteria used to determine RTS after HA. Themes and sub-themes were identified using a general inductive analysis and a coding process. A hierarchical approach in coding helped to link themes.
Four key themes and several subordinate themes were identified from the interviews that seem to influence the return to sports decision. The most important RTS criteria were muscle strength (especially symmetric hip strength and muscle bulk with low side-to-side variance compared to the contralateral side) followed by pain-free sport-specific activity (pain-free drill skills and play at a lower level), physical examination (with major emphasis on the absence of hip pain with a painless hip range of motion compared to the contralateral side), and functional testing (including full squats, Ober test, FABER test, and pain-free FADIR position).
Besides objective findings, including muscle strength, we identified time after surgery as well as subjective findings, including absence of pain and feedback of clinical team members that influence RTS decision after HA. We showed that even among specialized professional team physicians, the main criteria to RTS in these categories were not consistent necessitating the further development of specific RTS guidelines.
本研究旨在探讨目前精英运动员髋关节镜检查（HA）后用于重返运动（RTS）的标准，以深入了解职业队医在RTS决策过程中的新见解。作者假设，即使在这群高度专业化的医生中，用于确定HA后RTS的测量方法和标准也存在差异。
由一名经过培训的访谈者对职业队医进行了总共15次定性半结构化访谈。访谈用于确定队医关于HA后确定RTS标准的概念和主题。使用一般归纳分析和编码过程确定主题和子主题。编码中的分层方法有助于将主题联系起来。
从访谈中确定了四个关键主题和几个从属主题，这些主题似乎影响重返运动的决策。最重要的RTS标准是肌肉力量（特别是对称的髋部力量和与对侧相比侧方差异小的肌肉量），其次是无疼痛的特定运动活动（无疼痛的训练技能和较低水平的比赛）、体格检查（主要强调与对侧相比无髋部疼痛且髋关节活动范围无痛）和功能测试（包括全蹲、奥伯试验、FABER试验和无痛FADIR位）。
除了包括肌肉力量在内的客观发现外，我们还确定了手术后的时间以及主观发现，包括无疼痛和临床团队成员的反馈，这些都会影响HA后的RTS决策。我们表明，即使在专业的职业队医中，这些类别中RTS的主要标准也不一致，因此需要进一步制定具体的RTS指南。
