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Compared to a relatively older population over 30–40 years of age, the efficacy of biceps tenodesis for type II SLAP lesions in a younger population is not well studied. The purpose of this study was to compare outcomes between biceps tenodesis and labral repair for type II SLAP lesions in a young active population. Patients aged 15–40 who underwent primary arthroscopic biceps tenodesis or SLAP repair for type II SLAP tears between 2009 and 2016 were included. Shoulders with intraarticular chondral damage, full thickness rotator cuff tear, rotator cuff repair, labral repair outside of the superior labrum, bony subacromial decompression, and acromioclavicular joint resection were excluded. Patient-reported outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand Sports/Performing Arts Module (DASH-sport), visual analog scale (VAS) for pain, and satisfaction. Return to sport rates were also recorded. Fifty-three patients (20 tenodesis, 33 repair) were available for minimum 2-year follow-up. Postoperatively, there were no significant differences in mean ASES, DASH-sport, VAS, and satisfaction between groups [ASES: tenodesis 86.3 vs. repair 86.4 (n.s.); DASH-sport: 11.0 vs. 22.5 (n.s.); VAS: 1.85 vs. 1.64 (n.s.); satisfaction: 8.50 vs. 8.00 (n.s.)]. Rate of return to pre-injury level of performance/competition in sport/physical activity was also similar between groups [tenodesis 63% vs. repair 50% (n.s.)]. In a young active population, primary arthroscopic biceps tenodesis is a viable surgical alternative to labral repair for type II SLAP lesions. The results of this study suggest that indications for arthroscopic tenodesis can safely be expanded to a younger patient group than has previously been demonstrated in the literature. III.

Failure of hip preservation to alleviate symptoms potentially subjects the patient to reoperation or conversion surgery to THA, adding recovery time, risk, and cost. A risk calculator using an algorithm that can predict the likelihood that a patient who undergoes arthroscopic hip surgery will undergo THA within 2 years would be helpful, but to our knowledge, no such tool exists. (1) Are there preoperative and intraoperative variables at the time of hip arthroscopy associated with subsequent conversion to THA? (2) Can these variables be used to develop a predictive tool for conversion to THA? All patients undergoing arthroscopy from January 2009 through December 2011 were registered in our longitudinal database. Inclusion criteria for the study group were patients undergoing hip arthroscopy for a labral tear, who eventually had conversion surgery to THA. Patients were compared with a control group of patients who underwent hip arthroscopy for a labral tear but who did not undergo conversion surgery to THA during the same study period. Of the 893 who underwent surgery during that time, 792 (88.7%) were available for followup at a minimum of 2 years (mean, 31.1 ± 8.1 years) and so were considered in this analysis. Multivariate regression analyses of 41 preoperative and intraoperative variables were performed. Using the results of the multivariate regression, we developed a simplified calculator that may be helpful in counseling a patient regarding the risk of conversion to THA after hip arthroscopy. Variables simultaneously associated with conversion to THA in this model were older age (rate ratio, 1.06; 95% CI, 1.03–1.08; p

Compared to a relatively older population over 30-40 years of age, the efficacy of biceps tenodesis for type II SLAP lesions in a younger population is not well studied. The purpose of this study was to compare outcomes between biceps tenodesis and labral repair for type II SLAP lesions in a young active population.Patients aged 15-40 who underwent primary arthroscopic biceps tenodesis or SLAP repair for type II SLAP tears between 2009 and 2016 were included. Shoulders with intraarticular chondral damage, full thickness rotator cuff tear, rotator cuff repair, labral repair outside of the superior labrum, bony subacromial decompression, and acromioclavicular joint resection were excluded. Patient-reported outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand Sports/Performing Arts Module (DASH-sport), visual analog scale (VAS) for pain, and satisfaction. Return to sport rates were also recorded.Fifty-three patients (20 tenodesis, 33 repair) were available for minimum 2-year follow-up. Postoperatively, there were no significant differences in mean ASES, DASH-sport, VAS, and satisfaction between groups [ASES: tenodesis 86.3 vs. repair 86.4 (n.s.); DASH-sport: 11.0 vs. 22.5 (n.s.); VAS: 1.85 vs. 1.64 (n.s.); satisfaction: 8.50 vs. 8.00 (n.s.)]. Rate of return to pre-injury level of performance/competition in sport/physical activity was also similar between groups [tenodesis 63% vs. repair 50% (n.s.)].In a young active population, primary arthroscopic biceps tenodesis is a viable surgical alternative to labral repair for type II SLAP lesions. The results of this study suggest that indications for arthroscopic tenodesis can safely be expanded to a younger patient group than has previously been demonstrated in the literature.III.

To evaluate clinical outcomes, pain, and patient satisfaction following revision hip arthroscopy with a minimum 2-year follow-up.From April 2008 to October 2011, data were prospectively collected on all patients undergoing revision hip arthroscopy. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures: the modified Harris hip score (mHHS), nonarthritic hip score (NAHS), hip outcome score-activities of daily living (HOS-ADL), and hip outcome score-sport-specific subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. The number of patients who underwent subsequent revision arthroscopy or total hip arthroplasty during the study period is also reported.Eighty-seven patients underwent revision hip arthroscopy during the study period. Seventy (80.5%) patients were included in our study. Average follow-up time was 28 months (range, 20 to 47.4 months). In terms of residual femoroacetabular impingement morphology, 45.7% of patients had preoperative alpha angles ≥ 55°, and 7.14% of patients had a lateral center-edge angle ≥ 40°. The score improvement from preoperative to 2-year follow-up was 57.84 to 73.65 for mHHS, 62.79 to 83.04 for HOS-ADL, 37.33 to 54.93 for HOS-SSS, and 55.65 to 70.79 for NAHS. VAS decreased from 6.72 to 4.08. All scores demonstrated statistically significant improvement (P.001). Overall patient satisfaction was 7.67. Our success rate was 74.58%. Ten (14.29%) patients underwent total hip arthroplasty during the study period. Our hip survivorship was 85.7%. Five (7.14%) patients underwent secondary revision hip arthroscopy during the study period. We found an overall minor complication rate of 10%.Revision hip arthroscopy for all procedures performed on aggregate has improved clinical outcomes for all PROs, high survivorship, and high patient satisfaction scores at short-term follow-up. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty and the potential for revision surgery.Level IV retrospective case series.

This study compared 2-year clinical outcomes in hip arthroscopy patients treated with microfracture to a matched control group without full-thickness chondral damage.During the study period between June 2008 and July 2011, data were collected on all patients treated with hip arthroscopy who underwent microfracture. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures. Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. A matched-pair group of patients who did not undergo microfracture was selected in a 1:2 ratio. Matching criteria were age within 5 years, sex, surgical procedures, and radiographic findings.Average follow-up for the study was 26.66 months (17.29 to 48.89 months). Forty-nine hips were included in the microfracture group and 98 hips were in entered in the nonmicrofracture group, with no significant difference in PRO scores preoperatively between the groups. Both groups had statistically significant postoperative improvement in all scores, and the average amount of change from preoperative to postoperative scores between the 2 groups was not statistically significantly different for any of the PRO scores. Most importantly, there was no statistically significant difference in postoperative PRO scores between the microfracture and control groups. Patient satisfaction was 6.9 for the microfracture group and 7.84 for the nonmicrofracture group, which was statistically significant (P.05). When comparing patients who received acetabular microfracture to those who received femoral microfracture, both groups had similar preoperative and postoperative PRO scores, with no significant difference in the magnitude of change (delta) at final follow-up.Our study found that patients undergoing microfracture during hip arthroscopy did not show a statistically significant difference in PRO scores when compared with a matched-pair control group at an average of 2 years of follow-up. Both groups showed significant improvement in all PRO scores.Level III, matched case-control study.

Purpose: The purpose of this study was to investigate the influence of multiple demographic and radiographic findings on the size of labral tears identified at the time of hip arthroscopy. Methods: Data were prospectively collected for patients treated with arthroscopic labral repair or debridement from February 2008 to August 2011. Preoperative radiographic and demographic data were collected for 392 patients during the study period. Exclusion criteria included revision surgery and previous hip conditions. An anteroposterior pelvic view, 45 � Dunn view, and false-profile view were used to measure Tonnis grade, neck-shaft angle, alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA), acetabular inclination, and the extent of crossover sign when present. At the time of surgery, labral tear size and location were documented for all patients, using traditional acetabular clock face nomenclature for sizing. A multiple linear regression analysis was then performed to assess the correlation of radiographic and demographic findings with the size of the labral tear. Results: Regression analysis displayed statistical significance for sex (P < .0001), age (P < .0001), and alpha angle (P ¼ .005) with labral tear size. For female patients, Tonnis grade (P ¼ .0004) and neck-shaft angle (P ¼ .004) correlatedwithlabraltearsize.Thismodelaccountedforonly26%ofvariationinlabraltearsize.Conclusions: Preoperative risk factorsfortheextentoflabraltearsizearemalesex, increasingage, and increasingalphaangle.Labraltearswerelargerin female patients with higher Tonnis grades and lower neck-shaft angles. Measurements of acetabular coverage and version showed no correlation with labral tear size. The majority of labral tear size variation was not accounted for in this model. Level of Evidence: Level IV, therapeutic case series.

Background:There are currently no studies that have examined the recurrence of the cam lesion after femoral neck osteoplasty for femoroacetabular impingement. Although patient-reported outcome (PRO) scores at midterm follow-up have shown continued success, the maintenance of a normalized alpha angle has not been shown radiographically.Purpose:To assess the radiographic recurrence of cam deformity at 2-year follow-up after adequate decompression during the index hip arthroscopic procedure and correlate the findings with PRO scores. The hypothesis was that there would be no recurrence or regrowth of the cam deformity at the 2-year postoperative time point after adequate cam decompression during hip arthroscopic surgery.Study Design:Case series; Level of evidence, 4.Methods:Between March 2009 and January 2011, data were prospectively collected on all patients undergoing hip arthroscopic surgery with femoral neck osteoplasty. Minimum follow-up was 2 years, with radiographic images for review.Results:A total of 47 patients met the inclusion criteria. The mean age of the participants at the start of the study was 37.18 years (range, 31.70-47.43 years). There were 28 men (59.57%) and 19 women (40.43%). The mean follow-up duration was 28.32 months (range, 24-41 months). The mean preoperative alpha angle (Dunn view) was 70° (range, 60°-97°), compared with 42.79° (range, 32°-50°) at 2 weeks postoperatively ( P < .0001). The mean 2-year alpha angle was 42.72° (range, 32°-54°), which was not significantly different compared with the mean 2-week alpha angle ( P = .93). Additionally, the mean femoral offset measurement was 3.7 mm (range, 0-9.9 mm) preoperatively and 7.8 mm (range, 0.3-13.9 mm) 2 weeks postoperatively ( P < .0001). The mean 2-year postoperative femoral offset measurement was 8.0 mm (range, 2.4-12.8 mm), which was not significantly different compared with the mean 2-week femoral offset measurement ( P = .63). All PRO scores were significantly improved at 3 months compared with preoperative scores and, except for visual analog scale score, continued to show improvement at 2-year follow-up.Conclusion:There was no recurrence of cam deformity at 2 years after femoral neck osteoplasty for femoroacetabular impingement. PRO scores were improved at the 3-month and 2-year postoperative time points.

Background: Previous authors have suggested that intra-articular morphine and clonidine injections after knee arthroscopy have demonstrated equivocal analgesic effect in comparison with bupivacaine while circumventing the issue of chondrotoxicity. There have been no studies evaluating the effect of intra-articular morphine after hip arthroscopy. Purpose: To evaluate the efficacy of intra-articular morphine in combination with clonidine on postoperative pain and narcotic consumption after hip arthroscopy surgery for femoroacetabular impingement. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective chart review was performed on 43 patients that underwent hip arthroscopy for femoroacetabular impingement at a single institution between September 2014 and May 2015. All patients received preoperative celecoxib and acetaminophen, and 22 patients received an additional intra-articular injection of 10 mg morphine and 100 μg of clonidine at the conclusion of the procedure. Narcotic consumption, duration of anesthesia recovery, and perioperative pain scores were compared between the 2 groups. Results: Patients who received intra-articular morphine and clonidine used significantly less opioid analgesic (mEq) in the postanesthesia recovery (median difference, 17 mEq [95% CI, –32 to –2 mEq]; P = .02) compared with the control group. There were no differences in time spent in recovery before hospital discharge or in visual analog pain scores recorded immediately postoperatively and at 1 hour after surgery. Conclusion: Intraoperative intra-articular injection of morphine and clonidine significantly reduced the narcotic requirement during the postsurgical recovery period after hip arthroscopy. The reduction in postsurgical opioids may decrease adverse effects, improve overall pain management, and lead to better quality of recovery and improved patient satisfaction.

Objectives: The purpose of this study was to evaluate clinical outcomes, pain, and patient satisfaction following revision hip arthroscopy at a high volume referral center with a minimum 2-year follow-up. Methods: During the study period, April 2008 to October 2011, data was prospectively collected on all patients undergoing revision hip arthroscopy. All patients were assessed pre- and post-operatively with 4 patient-reported outcome (PRO) measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sport Specific Subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. Results: Eighty-seven patients underwent revision hip arthroscopy during the study period. Seventy (80.5%) patients were included in our study. In terms of residual FAI morphology, 45.7% of patients had preoperative alpha angles ≥55 degrees and 7.14% of patients had a LCEA ≥40 degrees. The score improvement from preoperative to 2-year follow-up was 57.84 to 73.65 for mHHS, 62.79 to 83.04 for HOS-ADL, 37.33 to 54.93 for HOS-SSS, 55.65 to 70.79 for NAHS. VAS decreased from 6.72 preoperatively to 4.08 postoperatively. All scores demonstrated statistically significant improvement (PConclusion: Revision hip arthroscopy for all procedures performed on aggregate has excellent clinical outcomes for all PROs and patient satisfaction scores at short-term follow-up. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty, and the potential for revision surgery.

Objectives: The most common reason for reoperation following arthroscopic hip surgery is conversion to total hip arthroplasty (THA). The purpose of this study was to identify clinical and radiographic risk factors for early conversion to THA. Methods: Data were prospectively collected on all hip arthroscopy patients from January 2009 through December 2011. Inclusion criteria for the study group were patients undergoing hip arthroscopy for a labral tear who eventually converted to THA. Patients were then compared to a control group of patients who underwent hip arthroscopy for a labral tear and did not convert to THA during the same period. Exclusion criteria were patients with previous hip conditions such as Legg-Calves-Perthes, slipped capital femoral epiphysis, pigmented villonodular synovitis, and avascular necrosis. A bivariate analysis of 41 preoperative and intraoperative variables was performed. Results: A total of 792 patients met inclusion and exclusion criteria. A total of 72 (9%) converted to THA. The control group consisted of 720 patients who did not convert to THA. Bivariate analysis demonstrated that the study group had significantly higher means or frequencies than the control group for the following variables: male gender, age at time of surgery, BMI, back pain, previous back surgery, Tönnis grade above 0, acetabular inclination angle, alpha angle, Seldes combined-type labral tear, labral tear size, chondral injury, traction time, labral debridement (versus repair), number of anchors used repair or reconstruction, and capsular release (versus repair). The study group had significantly lower means or frequencies than the control group for the following variables: preoperative patient reported outcome scores, crossover sign, lateral center edge angle, and psoas release. A statistically significant difference in average joint space was not observed. Conclusion: Multiple risk factors are possible preoperative and intraoperative risk factors for conversion to THA following hip arthroscopy. The clinician and patient should be aware of these variables.

Background: Microfracture in hip preservation surgery has demonstrated favorable outcomes, but studies with a higher level of evidence assessing microfracture are warranted. Purpose: To assess 2-year outcomes of patients who underwent hip arthroscopy with full-thickness chondral damage treated with microfracture and compare these outcomes with those of a control group from a similar cohort of patients who did not have full-thickness chondral damage and who were not treated with microfracture. Study Design: Cohort study; Level of evidence, 3. Methods: Between February 2008 and May 2012, prospectively gathered data for patients undergoing microfracture during hip arthroscopy with a 2-year follow-up were reviewed. All patients were assessed pre- and postoperatively at 3 months, 1 year, and 2 years with 4 patient-reported outcome (PRO) instruments. A matched cohort of patients who did not have full-thickness chondral damage and hence did not receive microfracture was selected on a 1:2 ratio. Matching criteria were sex, age within 6 years, workers’ compensation status, concomitant labral treatment, and radiographic parameters. Statistical analyses were performed to compare the change in PROs in both groups. Results: A total of 79 hips were included in the microfracture group and 158 in the control group. There was no significant difference in PRO scores preoperatively between the groups. Both groups demonstrated significant improvement in all postoperative PRO scores at all time points. There was no statistically significant difference in postoperative PRO scores between the microfracture and control groups, except for the visual analog scale (VAS) score at 2 years, which was higher ( P = .02) in the microfracture group (mean ± SD, 3.63 ± 2.50) than in the control group (2.82 ± 2.76). Patient satisfaction was 7.2 for the microfracture group and 8.04 for the control group, which was statistically different ( P < .05). The mean change in all PRO scores was similar between groups at 3 months and 1 year postoperatively but significantly lower in the microfracture group at 2 years postoperatively. The greatest improvement in both groups was noted at 3 months postoperatively. Conclusion: This study showed that patients undergoing microfracture during hip arthroscopy had equivalent PRO scores compared with the control group at 2 years postoperatively. The change in PRO scores from preoperatively to 2 years postoperatively was significantly lower in the microfracture group compared with the control group. The VAS scores and satisfaction were inferior by 0.81 and 0.84 units, respectively, in the microfracture group compared with the control group, likely due to lack of full-thickness chondral defects in the latter. However, both groups showed significant improvement in all PRO scores after surgery, with no significant difference in final PRO scores.

Patient-reported outcome (PRO) scores are used to evaluate treatment modalities in orthopaedic surgery. The method of PRO collection may introduce bias to reported surgical outcomes due to the presence of an interviewer. This study evaluates post-operative PROs for variation of outcomes between survey methods—in-person, online, or telephone. From 2008 to 2011, 456 patients underwent arthroscopic surgical treatment for acetabular labral tears. All pre-operative surveys were completed in the clinic during pre-operative visit. Two-year follow-up questionnaires were completed by 385 (84 %) patients. The PRO data were prospectively collected pre- and post-operatively using five tools: modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADLS), Hip Outcome Score Sports-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), and visual analog scale. Patients were grouped according to method of 2-year follow-up: in-person during follow-up visit (102 patients, 26 %), online by email prompt (138 patients, 36 %), or telephone with an interviewer (145 patients, 38 %). Pre-operative baseline PRO scores demonstrated no statistically significant difference between groups for mHHS, HOS-ADLS, HOS-SSS, and NAHS. Two-year post-operative PRO scores obtained by telephone were statistically greater than scores obtained in-person or online for mHHS (p

Previous studies assessed elite athletes' return to sport (RTS) after hip arthroscopy, but few investigated a cohort including athletes from all levels of sport. This study compared athletes who returned to sport to those who did not, based on four patient-reported outcome (PRO) scores, including the Hip Outcome Score-Sports Specific Subscale (HOS-SSS). Between September 2008 and April 2012, hip arthroscopies were performed on 157 patients (168 hips) who reported playing a sport preoperatively and indicated their level of sports activity post-operatively. Two-year follow-up was available for 148 (94%) amateur and professional athletes with a total of 158 hips. Of these 60 cases (65 hips) did not return to sports (NRTS) and were in the NRTS group. The remaining 88 cases (93 hips) constituted the RTS group. The modified Harris Hip Score, Non-Arthric Hip Score, Hip Outcome-Activities of Daily Living (HOS-ADL), and HOS-SSS were used to assess outcomes. The HOS-SSS was used to assess specific sport-related movement. Both groups demonstrated significant improvement at 2 years post-operatively in visual analog score and four PRO scores (P

Background: Hip arthroscopy has gained increasing popularity over the past decade. The need to develop metrics to evaluate success and complications in primary hip arthroscopy is an important goal. Purpose: To evaluate 2-year patient-related outcome (PRO) scores and patient satisfaction scores for a single surgeon at a high-volume referral center for all primary hip arthroscopy procedures performed. Study Design: Case series; Level of evidence, 4. Methods: During the study period between April 2008 and October 2011, data were collected on all patients who underwent primary hip arthroscopy. All patients were assessed pre- and postoperatively with 4 PRO measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), and Hip Outcome Score–Sport-Specific Subscale (HOS-SSS). Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. The number of patients who underwent revision arthroscopy, total hip arthroplasty (THA), or a resurfacing procedure during the study period was also reported. Results: A total of 595 patients were included in the study. The score improvement from preoperative to 2-year follow-up was 61.29 to 82.02 for mHHS, 62.79 to 83.05 for HOS-ADL, 40.96 to 70.07 for HOS-SSS, 57.97 to 80.41 for NAHS, and 5.86 to 2.97 for VAS. All scores were statistically significantly different ( P < .0001). Overall patient satisfaction was 7.86 ± 2.3 (range, 1-10). Forty-seven (7.7%) patients underwent revision hip arthroscopy, and 54 (9.1%) patients underwent either THA or the hip resurfacing procedure during the study period. The multivariate regression analysis showed that increased age at time of surgery was a significant risk factor for conversion to THA, revision arthroscopy, and change in NAHS Conclusion: Primary hip arthroscopy for all procedures performed in aggregate had excellent clinical outcomes and patient satisfaction scores at short-term follow-up in this study. More studies must be conducted to determine the definition of a successful outcome. There was a 6.1% minor complication rate, which was consistent with previous studies. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty as well as the potential for revision surgery.

Objectives: Full thickness chondral defects have been suggested to portend poor prognosis in hip arthroscopy. Although there is a small amount of data suggesting favorable outcomes with microfracture for such cases, no comparative studies have been performed to assess outcomes of full thickness chondral defects treated with microfracture. The purpose of this study is to compare two-year clinical outcomes of patients treated with microfracture to a matched control group that did not have full thickness chondral damage. Methods: During the study period, between June 2008 and July 2011, data were collected on all patients treated with hip arthroscopy who underwent microfracture. A matched-pair control group of patients who did not undergo a microfracture procedure was selected in a 1:2 ratio. Matching criteria were age within 5 years, sex, surgical procedures, and radiographic findings. All patients were assessed pre- and post-operatively with 4 patient-reported outcome (PRO) measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL), and Hip Outcome Score-Sport Specific Subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS), and satisfaction was measured on a scale from 0 to 10. Results: Forty-nine hips were included in the microfracture group and 98 in the control group. There was no significant difference in pre-operative PRO scores between the groups. For the microfracture group, the score improvement from preoperative to 2-year follow-up was 57.5 to 75.4 for mHHS, 53.6 to 71.8 for NAHS, 59.5 to 79.1 for HOS-ADL, and 35.5 to 55.5 for HOS-SSS. For the control group, the score improvement from preoperative to 2-year follow-up was 59.2 to 79.5 for mHHS, 54.4 to 76.2 for NAHS, 60.6 to 80.4 for HOS-ADL, and 38.6 to 64.2 for HOS-SSS. Both groups demonstrated statistically significant postoperative improvement in all scores (p Conclusion: Our study demonstrated that patients receiving microfracture during hip arthroscopy did not show a statistically significant difference in PRO scores when compared to a matched-pair control group at two year follow-up. Both groups demonstrated significant improvement in all PRO scores. These results show that microfracture appears to be a viable treatment option for grade IV cartilage damage identified at the time of hip arthroscopy. Furthermore, full thickness chondral defects may not necessarily portend an inferior functional prognosis when treated with microfracture

Background: Shoulder injuries remain one of the most common injuries among collegiate football athletes. Offensive linemen in particular are prone to posterior labral pathology. Purpose: To evaluate the efficacy of shoulder bracing in collegiate offensive linemen with respect to injury prevention, severity, and lost playing time. Study Design: Cohort study; Level of evidence, 3. Methods: Offensive linemen at a single collegiate institution wore bilateral shoulder-stabilizing braces for every contact practice and game beginning in the spring of 2013. Between spring of 2007 and fall of 2012, offensive linemen did not wear any shoulder braces. Player injury data were collected for all contact practices and games throughout these time periods to highlight differences with brace use. Results: Forty-five offensive linemen (90 shoulders) participated in spring and fall college football seasons between 2007 and 2015. There were 145 complete offensive linemen seasons over the course of the study. Offensive linemen not wearing shoulder braces completed 87 seasons; offensive linemen wearing shoulder braces completed 58 seasons. Posterior labral tear injury rates were calculated for players who wore the shoulder braces (0.71 per 1000 athlete-exposures) compared with shoulders of players who did not wear the braces (1.90 per 1000 athlete-exposures). The risk ratio was 0.46 (95% CI, 0.16-1.30; P = .14). Mean time (contact practices and games) missed due to injury was significant, favoring less time missed by players who used braces (8.7 vs 36.60 contact practices and games missed due to injury; P = .0019). No significant difference in shoulder labral tears requiring surgery was found for brace use compared with no brace use. Conclusion: Shoulder-stabilizing braces were shown not to prevent posterior labral tears among collegiate offensive lineman, although they were associated with less time lost to injury. The results of this study have clinical significance, indicating that wearing a shoulder brace provides a protective factor for offensive linemen.

Objectives: Previous studies have assessed elite athletes’ level of return to sport, but few have investigated a general hip arthroscopy cohort. The study purpose was to compare patient-reported outcomes (PRO) scores and ability to perform sports-related movements between a group of patients that returned to sport (RTS) and a group that did not return to sports (NRTS). Methods: Between September 2008 and April 2012, 1343 patients underwent hip arthroscopy, of which, 157 patients (168 hips) reported playing a sport before surgery and also indicated their postoperative involvement in sports. Of these, 148 patients (158 hips, 94%) had two-year follow-up. Four PROs were used. The Hip Outcome Score - Sports Specific Subscale (HOS-SSS) was the primary measure to assess return to sports and ability to perform sport-related movements. Results: In the overall cohort of 148 amateur and professional athletes (158 hips) who underwent hip arthroscopies, 25 (17%) did not return to sports due to hip-related issues. An additional 32 patients (22%) did not return to sports due to non-hip-related issues, while three patients did not return sports for unidentified reasons. These 60 patients (65 hips) were considered the NRTS group. The remaining 88 patients (93 hips) were defined as the RTS group. Average ages for the RTS and NRTS groups were 30.7 and 30.4 years, respectively. Both groups demonstrated significant improvements from preoperative to postoperative scores based on all PRO measures. While there was no significant difference between groups for HOS-SSS scores preoperatively, the RTS group had significantly higher HOS-SSS scores at one year and two years post-surgery. Postoperatively, patients in the RTS group had significantly better ability to: run one mile, jump, land from a jump, stop quickly and perform cutting/lateral movements (p20 at two years post-surgery were 2.3 times as likely to return to sport as those with HOS-SSS < 20. Conclusion: In a mixed group of hip arthroscopy athletes, 84% returned to sport or discontinued participation due to non-hip related issues. Patients who returned to sport demonstrated significantly higher HOS-SSS scores and abilities to perform several sport-related movements. movements.

Objectives: Early skepticism of surgery for femoroacetabular impingement arose in part from suspicion that the cam lesion on the femoral head-neck junction would recur after initial resection. There are currently no studies that have looked at the recurrence of the cam lesion after femoral neck osteoplasty for femoroacetabular impingement (FAI). While Patient Related Outcome (PRO) scores at mid-term follow-up have shown continued success, the maintenance of a normalized alpha-angle has not been shown radiographically. The purpose of the study was to assess the radiographic recurrence of cam deformity at 2-year follow-up after adequate decompression during the index hip arthroscopy and correlate with PRO scores. Our hypothesis is there will be no recurrence or regrowth of the cam deformity at the two-year postoperative time-point following adequate cam decompression during hip arthroscopy. Methods: Between March 2009 and January 2011 data was prospectively collected on all patients undergoing hip arthroscopy with femoral neck osteoplasty. Inclusion criteria consisted of all patients during the study period with preoperative alpha angles greater than 60 degrees and postoperative alpha angle less than 50 degrees after femoral osteoplasty. Minimum follow-up was two years with radiographic images for review. Results: A total of 47 patients met inclusion criteria. The mean age of our study group was 37.18 (31.7 - 47.43) years at the start of the study. There were 28 males (59.57%) and 19 females (40.43%). The mean follow-up was 28.32 months. Mean preoperative alpha angle (Dunn view) was 70 degrees (60-97 degrees). At 2-week postoperative follow-up, the mean alpha angle was 42.79 degrees (32-50 degrees) (pConclusion: There is no recurrence of cam deformity at 2-years following femoral neck osteoplasty for FAI with improved PRO scores at the 3-month and 2-year postoperative time-points.

Background: Professional American football is a physically demanding, high-impact sport with an elevated risk of injury. Orthopaedic injuries may impose acute, short-term or cumulative consequences throughout a player’s lifetime. Several studies have addressed health and psychosocial concerns of an older, retired population of players in the National Football League (NFL); however, minimal research has examined the orthopaedic toll on younger, retired players. Purpose: This study reports total whole-person impairment (WPI) percentages in a cohort of younger, retired NFL players who presented for disability evaluations based on the use of standardized American Medical Association (AMA) impairment guidelines. Study Design: Case series; Level of evidence, 4. Methods: During the study period of February 2011 to August 2013, 65 younger retired NFL players presented for impairment evaluations. The mean time between retirement and impairment evaluation was 3.1 years (range, 0.3-16.4 years). A complete history and physical examination was performed on all symptomatic joints. A retrospective chart review was conducted on 100% of presenting players to assess orthopaedic burden. Body-part impairment (BPI) percentage for each affected joint was generated. The impairment data for each extremity were then combined with spine impairment data to create WPI percentage. Player demographics, including age, position, and playing time, were also recorded. Results: The average WPI percentage was 37% (range, 19%-53%). Players participating in >30 games (n = 54) had a higher mean WPI percentage (38%) than those playing in 5 seasons (n = 46) were 2.4 times more likely to have a WPI of at least 37% ( P = .007). The most common joints players reported as symptomatic were lumbar (n = 63; 97%) and cervical spine (n = 58; 89%). The mean age at evaluation was 33.5 years (range, 27-42 years), and the mean number of seasons played was 7.5 (range, 3-14 seasons). The mean number of games played was 98.4 (range, 2-236 games). Conclusion: This study demonstrated high WPI percentages related to symptomatic joints in a cohort of younger, retired NFL players. Further research is warranted to study potential cumulative physical and quality of life factors related to high impairment percentages in younger, retired NFL players.