A qualitative assessment of return to sporting activity after hip arthroscopy for femoroacetabular impingement

Hip arthroscopy for femoroacetabular impingement is known to produce excellent results, yet some patients do not return to their pre-injury level of sporting activity. A great deal of data has been published in the international literature on return to sporting activity after reconstruction of the anterior cruciate ligament and for shoulder instability, but to date no data from qualitative studies have been used in patients with tears of the acetabular labrum.
In a recently published study, the authors set out to understand the factors that influence the decision to return to sporting activity after arthroscopic hip surgery for femoroacetabular impingement.
Contact was made through qualitative, semi-structured interviews with patients aged 18 to 60 years who had undergone arthroscopic hip surgery for femoroacetabular impingement. All had taken part in sporting activity before the injury and had a minimum of two years of follow-up without repeat surgery. A qualitative analysis was then carried out in order to derive codes, categories and themes. An assessment of sporting activities before and after the injury was also obtained, by type, level of participation and frequency, together with the patient-reported function of the hip. The Modified Harris Hip Score, International Hip Outcome Tool and Hip Outcome Score-sports-specific subscale hip outcome scores were also recorded.
In all, 23 patients were interviewed in order to bring out the themes of return and of internal motivation, external encouragement and the resetting of expectations as the dominant factors influencing the patient's decision to return to their pre-injury sporting activity. The subjective outcome measures showed significant differences between the patients who returned and those who did not return to sporting activity.
The authors concluded that self-motivation, increasing age, pain, encouragement from others and adaptation to physical limitations can have a very strong influence on the patient's decision to return to sporting activity after arthroscopic hip surgery. Intrinsic mechanisms on the patient's part may also help in predicting the course of, and the support needed in, the patient's postoperative rehabilitation.
Source: “Orthopaedic Journal of Sports Medicine”, November 2016