Meta-Analysis of the Surgical and Rehabilitative Outcomes of Hip Arthroscopy in Athletes With Femoroacetabular Impingement.

ABSTRACT

OBJECTIVES: Femoroacetabular impingement (FAI) poses a threat to athletes' capacity to compete. This review aims to estimate the rate of return to sport after hip arthroscopy for treatment of FAI as well as identify factors that may affect athletes' outcomes. DESIGN: Meta-analysis. METHODS: Four databases (EMBASE, PubMed, Web of Science, and Cochrane) were searched in July 2015 by 2 reviewers. Studies were required to include athletes who were treated with hip arthroscopy for symptomatic FAI and also report return to sport as an outcome. A validated tool was used for quality assessment and level of agreement between raters was calculated. A meta-analysis for proportions returning to sport was performed on the available data using MedCalc software. Additional outcomes were descriptively analyzed. RESULTS: A total of 15 case series involving 823 patients were included in the review, with moderate to high methodological quality. 88.3% [95% confidence interval (CI), 83.4%-92.4%] of athletes returned to sport after arthroscopy and 85.3% (95% CI, 77.6%-91.6%) returned to preinjury level. All outcome measures used reported measurable improvements. Complication rates were low. CONCLUSIONS: The majority of athletes return to sport after hip arthroscopy for symptomatic FAI. Severity of intraarticular damage and degree of degenerative changes affect ability to return to sport. Additional validated outcome measures should be used together with return to sport. Future studies should be prospective with longer-term follow-up to provide a higher level of evidence for outcomes.