Return to play after hip arthroscopy with microfracture in elite athletes

Abstract

Purpose: The purpose of this study was to compare elite athletes who underwent hip arthroscopy with and without microfracture with respect to their ability to return to sport at the professional level.

Methods: All elite male athletes who underwent hip arthroscopy between 1999 and 2010 were identified. Inclusion criteria were hip arthroscopy with treatment of labrum, femoroacetabular impingement, cartilage, ligamentum teres, capsule, and/or loose body removal. Exclusion criteria were diffuse degenerative joint disease, previous surgery, plans to retire, labral reconstruction, soft tissue release, and concomitant lower extremity injury. Thirty-nine athletes underwent hip arthroscopy with microfracture and were assigned to the microfracture treatment group. Eighty-one elite athletes (94 hips) underwent hip arthroscopy without microfracture and were assigned to the control group. Sports played included hockey, soccer, football, baseball, tennis, and golf.

Results: Seventy-seven percent (30 of 39) of athletes in the microfracture treatment group and 84% (79 of 94) in the control group returned to play. There was no statistical difference in rate of return to play between groups (odds ratio = 1.6; 95% confidence interval, 0.633 to 4.049). Those players who did return were followed for an average of 3 years (range, 2 to 12). Athletes in the microfracture treatment group who returned have averaged 3 seasons thus far, and 73% are still playing. We found no significant difference in the microfracture group in age, time from injury to surgery, number of seasons played preoperatively, or size of lesion for return versus no return. We also found no increased risk of not returning because of contact sport, multiple lesions, or lesion on weightbearing surface.

Conclusions: There was no detectable statistically significant difference in return to play rate after hip arthroscopy with microfracture and hip arthroscopy without microfracture. Professional athletes who underwent hip arthroscopy with microfracture procedure were able to return to the same high level of competition after surgery at a high rate.

Level of evidence: Level III, retrospective comparative study.