Arthroscopic correction of femoroacetabular impingement improves athletic performance in male athletes

Knee Surg Sports Traumatol Arthrosc. 2020 Jul;28(7):2285-2294. doi: 10.1007/s00167-019-05683-0. Epub 2019 Aug 28.

Abstract

Purpose: To measure the changes in athletic performance in athletes treated arthroscopically for femoroacetabular impingement and compare results to a matched controlled athletic cohort, over a 1-year period.

Methods: Male athletes scheduled for arthroscopic correction of symptomatic FAI were recruited and tested (pre-operatively and 1-year postsurgery) for measures of athletic performance which included acceleration (10-m sprint), change of direction speed (CODS), squatting depth, and reactive strength index (RSI). The FAI group was compared to a matched, healthy, control group who were tested at baseline and 1 year later with no disruption to their regular training or competition status; the prevalence of anterior groin pain during testing in either group was recorded. Hip range of motion (ROM) was also measured for both groups at baseline and at 1 year in the FAI group to look for change following intervention.

Results: Prior to surgery, the FAI group were slower than the control group (p < 0.001) for acceleration (3% slower) and CODS (10% slower). At 1 year, 91% of the FAI group returned to full competition at an average time of 17 weeks, while substantial reductions in pain were also noted during acceleration (51-6%, p = 0.004), CODS (62-8%, p = 0.001), and squat test (38-8%, p = 0.003). Significant improvements were seen in the FAI group for CODS (7%, p < 0.001) and squat depth measures (6%, p = 0.004) from baseline to 1 year (significant time × group interaction effects were noted for these also). The changes in performance in the control group over time were non-significant across all of the measures (n.s.). At 1-year postsurgery, there were no statistically significant differences between the groups for any of the athletic measures. There was a significant and clinically important improvement in range of hip motion in the FAI group at 1-year postsurgery (p < 0.05).

Conclusion: Symptomatic FAI causes substantial reductions in athletic performance compared to healthy competitors placing these athletes at a distinct performance disadvantage. The results from the current study demonstrate that arthroscopic correction (including labral repair) in athletes with symptomatic FAI, reduces pain and restores athletic performance to a level which is comparable to healthy athletes, at 1 year.

Level of evidence: II.

Keywords: Arthroscopy; Athletes; Athletic performance; FAI; Femoroacetabular impingement; Hip injury; Sports injury.

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy* / methods
  • Athletic Injuries / physiopathology
  • Athletic Injuries / surgery*
  • Athletic Performance*
  • Cohort Studies
  • Exercise Test
  • Femoracetabular Impingement / physiopathology
  • Femoracetabular Impingement / surgery*
  • Humans
  • Male
  • Range of Motion, Articular
  • Treatment Outcome
  • Young Adult