Athletes return to elite sport after hip reconstruction

By Andrew Czyzewski

Around three-quarters of elite athletes who undergo arthroscopic labral reconstruction of the hip successfully return to their sport at the same level of competition they were at prior to surgery, a review shows.

Although a small study, the research "supports the use of this procedure in high level athletes who present with hip pain secondary to labral deficiency," according to co-author Marc Philippon (Steadman Philippon Research Institute, Vail, Colorado, USA) and colleagues.

Labral tears in the hip are often associated with a traumatic injury, such as dislocation, but researchers say they are increasingly seeing hip issues due to repetitive motions and underlying structural abnormalities.

"The proper function of the labrum in the hip is a critical component of mobility for any athlete. When this area gets hurt, repair can be difficult," said Philippon, who presented the findings at the American Orthopaedic Society for Sports Medicine's Annual Meeting in Baltimore, Maryland, USA.

One reconstructive approach to address a labral deficiency has been reported using an arthroscopic technique with iliotibial band autograft.

For the current study, the researchers reviewed data to identify elite athletes who underwent a labral reconstruction between 2005 and 2010.

In all, there were 22 professional athletes (all male) with an average age of 28.8 years, of whom eight were involved in soccer, five hockey, four football, one basketball, one baseball, two skiing, and one ice skating.

The mean preoperative Modified Harris hip score (MHHS) was 62; Hip Outcome Score (HOS) 77; WOMAC score (Hip disability and Osteoarthritis Outcome), 24; and the 12-Item Short Form Health Survey (SF-12) physical component score, 42.8.

Follow up was available for 18 (82%) of the 22 athletes for an average of 31.2 months.

Philippon and team report that all patients displayed improved outcome scores, with the mean postoperative MHHS rising to 81; HOS to 86; WOMAC to 11.1; and SF-12 to 49.4.

Of the athletes, 86% returned to elite sports with 73% successfully returning to prior level of play.

"Our review study highlights that a majority of athletes can return to a solid level of play utilizing the ipsilateral iliotibial band autograft and physical therapy. While additional research needs to be performed on the technique, we are hopeful that its increased use will allow more athletes the ability to return to the sports they love," said Philippon.

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