Return to Sport in Elite-Level Athletes Undergoing Hip Arthroscopy Varies Based on Return-to-Sport Definition: A Systematic Review.

Abstract

To provide an updated review of return-to-sport rates and outcomes for elite athletes undergoing hip arthroscopy and to discuss the impact of varying definitions of return to sport in the current literature. A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies reported a return-to-sport rate for elite athletes undergoing hip arthroscopy for treatment of femoroacetabular impingement and/or labral tears. Only elite athletes, defined as those competing at the Olympic, national, professional, semiprofessional, or collegiate levels, were included. Extracted data included patient demographic data, sports played, level of competition, return-to-sport rates, time to return to sport, patient-reported outcomes, intraoperative findings, surgical interventions, and radiological data. A total of 1406 patients and 1548 hips across 21 studies were included in this analysis. Included studies had mean ages at the time of surgery ranging from 19.5 to 38 years. The proportion of male athletes varied from 42% to 100%, and body mass indices ranged from 22.9 to 31.4 kg/m². A total of 18 studies reported a return-to-sport rate where return was specifically defined as a return to the same level of competition, with rates ranging from 25% to 100%. Nine studies included a broader definition of return to sport, with rates ranging from 67% to 100%. Mean time to return to sport across studies ranged from 4.2 to 10.8 months, and mean follow-up periods ranged from 12.3 to 92.4 months. Reported return-to-sport rates for elite athletes undergoing hip arthroscopy were high. However, there exists much variability in the characterizations of return to sport, which results in inconsistent return rates that must be contextualized for patients and surgeons to make informed decisions. Level IV, systematic review of Level III and IV studies.