SURGICAL DISLOCATION OF THE HIP FOR THE TREATMENT OF FEMOROACETABULAR IMPINGEMENT IN PROFESSIONAL ATHLETES

Abstract

Evidence has emerged that femoroacetabular impingement (FAI) may instigate early osteoarthritis of the hip and that symptomatic patients can be successfully treated by addressing the underlying pathomorphology. There is also an increasing body of evidence to support FAI as one major cause of hip and groin pain, decreased mobility and reduced performance in athletes. This study therefore aimed to investigate if professional athletes with FAI can resume to their sports after a surgical dislocation of the hip and continue their professional career up to a mid-term follow-up. We identified fifteen professional athletes (21 hips, all cam-type or mixed-type FAI, mean alpha-angles of 68°) who underwent a surgical hip dislocation for FAI treatment. Surgery was performed by the senior author in all cases. The patients were evaluated by postal survey at a mean of 47 months (range, 9–79) postoperatively. The evaluation inquired about the type and level of sports, subjective ratings, and clinical outcomes (Hip Outcome Score [HOS], SF-12, UCLA activity scale, FAI sports scale [FSS], VAS pain). At follow-up, 14 of the 15 patients (93%) were still professionally sports active. Twelve athletes maintained their levels and two were active in minor leagues. Eleven patients (75%) were satisfied with their hip surgery and their sports ability. Mean activity levels were 7.5 according to the self-developed FSS and 9.7 according to the UCLA scale, respectively. Mean scores of the HOS ADL and Sport subscales were 92.6 and 85.2, respectively. Mean scores of the SF-12 PCS and MCS were 50.7 and 56.1, respectively. Pain levels during sports were rated to be 2.0 according to the VAS. In conclusion, this study highlighted that professional athletes suffering from FAI can successfully return to professional sports after a surgical dislocation of the hip. All athletes except one (93%) could continue their professional career up to the follow-up four years after surgery. Clinical outcomes in terms of subjective ratings and scores were encouraging, nevertheless, longer-term follow-up has to show if results deteriorate with time considering the exhaustive joint use related to a professional sports career.