Hip Arthroscopy Yields Favorable Outcome, Return-to-Sport Rate, and 5-Year Survivorship in Athletic Population With Generalized Ligamentous Laxity in the Treatment of Femoroacetabular Impingement and Labral Tears.

Abstract

To evaluate the minimum 5-year clinical outcomes and return-to-sport (RTS) rates of patients with generalized ligamentous laxity (GLL) who underwent hip arthroscopy with a secondary comparison to a benchmark control group with no GLL. We retrospectively analyzed all patients with GLL (Beighton score ≥ 4) who underwent primary hip arthroscopy between November 2009 and January 2019. We included patients who reported preoperative sport participation and had preoperative and minimum 5-year follow-up for at least one patient-reported outcome (PRO) measure: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), International Hip Outcome Tool-12 (iHOT-12), or Visual Analog Scale (VAS) for pain. Revision hip arthroscopy or conversion to arthroplasty was accounted for. Patients with GLL were matched to patients with a Beighton score of <3. Rates of meeting the minimal clinically important difference (MCID), RTS, and having secondary surgery were analyzed. Two hundred thirty-two hips were included, with 116 hips in the GLL group (age: 27.3 years, BMI: 23.7 kg/m²) (78.7% follow-up) and 116 in the control group (age: 28.4 years, BMI: 23.6 kg/m²). Patients in the GLL group showed significant improvement in all evaluated PROs (mHHS: 66.1-86.7, NAHS: 67.6-87.0, iHOT-12: 40.1-78.2, HOS-SSS: 45.0-79.7, VAS: 4.9-2.1; P < .01). MCID was met at similarly high rates for both groups (P > .05). Patients with GLL reported a RTS rate of 83% at any time point postoperative, and 74.6% of those that returned were able to continue playing at the 5-year mark. No differences in postoperative PRO scores, RTS, continuation-of-sport participation, and survivorship were found between groups. Hip arthroscopy in patients with GLL yields favorable outcomes and survivorship at 5-year minimum follow-up comparable to patients without GLL. A high percentage of athletes with GLL were able to RTS and continue playing 5 years after hip arthroscopy. Level IV, retrospective comparative case series.