A new analysis, conducted by Dr. Okoroha's colleagues examined outcomes related to hip arthroscopy. Their research highlights an important takeaway, while new techniques continue to evolve, long-term data remains critical in determining the best approach. Here's what they found.
https://arthroscopyjournals.onlinelibrary.wiley.com/doi/10.1002/arj.70523
Hip dysplasia can cause pain and interfere with athletic performance when the hip socket does not provide adequate coverage of the femoral head. For competitive athletes, an important question is whether surgical treatment will allow them to return to their sport—and whether they can compete at the same level afterward.
A recent study evaluated competitive athletes with hip dysplasia who underwent hip arthroscopy combined with periacetabular osteotomy, or HA + PAO.
The study found that 93.18% of the athletes returned to sports. Most returned at the same or a higher competitive level than before surgery.
What Are Hip Arthroscopy and Periacetabular Osteotomy?
Hip arthroscopy and periacetabular osteotomy are two procedures that may be performed together to treat hip dysplasia.
Hip arthroscopy allows the surgeon to examine and treat problems within the hip joint. Periacetabular osteotomy, commonly called PAO, is performed to correct the dysplasia.
In this study, every included athlete underwent both procedures during the same surgical treatment.
Who Was Included in the Study?
Researchers retrospectively reviewed competitive athletes who underwent combined hip arthroscopy and PAO for hip dysplasia between January 2016 and December 2023.
All procedures were performed by a single orthopaedic surgeon.
The study excluded:
- Patients who underwent PAO without hip arthroscopy
- Patients who participated only in recreational sports
- Patients without documentation that they attempted or wanted to return to sports
Researchers initially identified 48 patients involving 56 hips. Four patients were lost to follow-up, leaving 44 athletes and 52 treated hips in the final analysis.
The group included:
- 37 women
- 7 men
- 8 patients who underwent surgery on both hips
A minimum follow-up period of two years was attempted for all patients.
What Levels of Athletes Were Evaluated?
The study included athletes competing at several levels:
- 16 high school athletes
- 6 athletes competing at both the high school and competitive-club levels
- 12 competitive-club athletes
- 9 college athletes
- 1 professional athlete
Competitive-club participation included regional, national, or international competition.
The researchers recorded each athlete's sport and competitive level before and after surgery. Return to sport was then classified as returning at a lower, equal, or higher level than before the procedure.
What Was the Overall Return-to-Sport Rate?
Of the 44 athletes included in the analysis:
- 41 returned to sports.
- 3 did not return to sports.
This produced an overall return-to-sport rate of 93.18%.
The finding demonstrates that a large majority of the competitive athletes in this study successfully returned to athletic participation following combined hip arthroscopy and PAO.
Did Athletes Return at the Same Competitive Level?
Returning to a sport does not necessarily mean returning at the same level of competition. The researchers therefore examined how each athlete's postoperative level compared with their preoperative status.
Among the 41 athletes who returned:
- 33, or 80.49%, returned at the same competitive level.
- 5, or 12.19%, returned at a higher competitive level.
- 3, or 7.32%, returned at a lower competitive level.
Overall, 38 of the 44 athletes—86.36% of the entire study group—returned at the same or a higher level of competition.
These results suggest that most athletes did more than simply resume participation. They were able to return without reducing their competitive level, and several progressed to a higher level after surgery.
How Long Were the Athletes Followed?
Information about subsequent surgeries was available for 39 of the 44 patients, representing 88.63% of the study group.
These patients had a minimum follow-up period of two years. The average follow-up was 47.78 months, with individual follow-up periods ranging from 24 to 120 months.
This means some athletes were followed for as long as 10 years after surgery.
Were Additional Surgeries Required?
Three patients experienced complications that required a return to the operating room.
The abstract does not describe the specific complications or procedures performed. Therefore, these results show that additional surgery was necessary for some patients but do not provide enough information to explain the individual circumstances.
What Do These Results Mean for Competitive Athletes?
The study reported a high rate of return to sport among competitive athletes treated with combined hip arthroscopy and PAO for hip dysplasia.
Its principal findings included:
- 93.18% of athletes returned to sports.
- 86.36% of the entire group returned at the same or a higher competitive level.
- 80.49% of returning athletes resumed competition at their previous level.
- 12.19% of returning athletes progressed to a higher level.
- Only three of the 44 athletes did not return to sports.
The study included athletes from high school through the professional level, showing that return was possible across several levels of competitive participation.
However, these results represent the outcomes of a specific group treated by one orthopaedic surgeon. Recreational athletes and patients treated with PAO alone were not included.
The Bottom Line
Competitive athletes with hip dysplasia demonstrated a high rate of return to sport after combined hip arthroscopy and periacetabular osteotomy.
More than 93% returned to athletic participation, while approximately 86% of the entire study group returned at the same or a higher level of competition. Although three patients required additional surgery because of complications, most athletes successfully resumed competitive sports.
For athletes considering treatment for hip dysplasia, these findings provide encouraging evidence that returning to meaningful competition may be possible following HA + PAO.
We are committed to providing personalized care and innovative treatments to help patients return to peak performance safely and effectively. To learn more about hip arthroscopy, schedule a consultation with Dr. Kelechi Okoroha today.
Seeing patients in Dallas, Richardson, Frisco, and beyond, Dr. Okoroha provides specialized care focused on optimizing recovery, performance, and long-term joint health.
