Abstract
Objectives:
Femoroacetabular impingement syndrome (FAIS) is a common cause of pain in the active, nonarthritic hip population. Hip arthroscopy with osteoplasty and labral repair leads to clinically meaningful improvement in patients with FAIS. However, gaps exist in evaluating outcomes among different subsets of athletes, and specifically runners. This study aims to compare the outcomes of runners versus non-runners after arthroscopic surgery for FAIS and we hypothesized the groups would have similar postoperative outcomes at 2 years.
Methods:
Data were prospectively collected from patients with 2-year follow up after arthroscopic treatment for FAIS between October 2017 and August 2021. Patients were eligible if they underwent primary hip arthroscopy for FAIS (labral repair and osteoplasty), had preoperative and 2-year postoperative Hip Disability and Osteoarthritis Outcome Scores (HOOS), and completed a preoperative questionnaire on athletic activity. Patients were divided into two cohorts according to self-reported activities: Runners and Non-Runners. Primary outcome was the change in HOOS score at 2 years. Additional predictors included age, sex, body-mass index (BMI), smoking, education, and preoperative HOOS scores. Data were analyzed using Wilcoxon rank sum and chi square as appropriate, and linear regression analysis was performed to limit confounding with alpha level at 0.05.
Results:
A total of 263 patients were included: 44 in the Runner cohort (17%) and 219 (83%) in the Non-Runner cohort. Runners were more likely to have a college education (p = 0.015). All other variables including age, BMI, preoperative radiographic and intraoperative findings were similar between groups. Preoperative HOOS scores were similar between groups (52.6 vs 47.5, p = 0.59). Postoperative HOOS improved by a clinically significant margin in all subscales for both groups at 2 years after surgery, with significantly better improvement for runners than non-runners (31.6 vs 23.9, p = 0.045). However, on linear regression analysis runners only trended toward better improvement in each subscale (all p > 0.05), with other predictors such as smoking status and education level playing a larger role.
Conclusions:
This prospective cohort study found that runners and non-runners have similar, clinically significant improvements in patient-reported outcomes at 2 years after surgery. Smoking and lower education level led to less improvement on multivariable analysis. These results provide valuable information for runners with FAIS on their expected outcomes after surgery.