Assessing long-term return to play after hip arthroscopy in football players evaluating risk factors for good prognosis
PURPOSE To study the return to sport in a series of professional athletes in a single sport (Australian Rules Football), operated on arthroscopically for hip joint pathology. METHODS We performed a retrospective review of the senior author's surgical database starting in 2003. All of the patients who were Australian Football League (AFL) professional players with a minimum of 2 years' follow-up were included. Intra-articular pathologies were identified and treated. All patients were prospectively assessed with the modified Harris Hip Score (MHHS) and the Non-Arthritic Hip Score (NAHS). In addition, information about the active participation of the patients in their teams and return to professional sport was obtained from AFL registers and team physicians. RESULTS Since 2003, the senior author has operated on 36 male professional AFL players; 26 of 27 with at least 2 years' follow-up were available for review. The mean age at the time of surgery was 22.1 years (range, 16 to 30 years), and 8 patients had bilateral pathology; therefore 34 hips were operated on. This report refers to those 26 players and 34 hips. All but 1 of the patients returned to play professionally. By the last survey (October 2011), 16 patients (62%) were still playing professional AFL football, and they have been playing for a mean of 52.5 months after surgery. Ten patients had retired from professional football, but they had all returned to play professionally after surgery. Only one of them retired for causes related to hip disability. There was a significant improvement in preoperative outcome scores. The MHHS and NAHS improved from 83.6 to 98 and from 85.3 to 97.1, respectively, in the players who were still playing (P < .05). Rim lesions were present in 33 hips (97%). Femoral osteochondroplasty was performed in 26 hips (76%). CONCLUSIONS Arthroscopic treatment of intra-articular pathologies in professional athletes resulted in a 96% rate of return to elite-level sport and a durable increase in the MHHS and NAHS. LEVEL OF EVIDENCE Level IV, therapeutic case series.