Comparative outcomes of hip arthroscopy for femoroacetabular impingement in football and non-football athletes: a clinical analysis

Abstract

Introduction: Femoroacetabular impingement (FAI) is a common cause of hip pain and dysfunction, particularly among athletes, including football players. The condition is characterized by abnormal contact between the femoral head-neck junction and the acetabulum, leading to cartilage damage and labral tears. Hip arthroscopy has emerged as a minimally invasive treatment option, offering faster recovery and improved outcomes compared to traditional surgery. This study aims to compare outcomes between football players and non-football athletes undergoing hip arthroscopy for FAI. Materials and methods: This retrospective, single-center study analyzed a database of patients undergoing hip arthroscopy for FAI between 2007 and 2023. The study compared football players (n = 16) and non-football athletes (n = 16), matched for age, sex, and BMI. Pre-operative assessment included the Hip Outcome Score (HOS), Visual Analog Scale (VAS), and other functional questionnaires. Radiographic evaluations included the alpha and Wiberg angles, and intra-operative findings were recorded. The surgical approach involved femoral and acetabular osteoplasty, labral repair, or labrectomy, depending on injury morphology. Results: Both groups showed similar pre-operative pain levels (VAS) and functional scores. However, significant differences were observed in the Tegner and Hip Sports Activity Scores (HSAS), with football players showing higher activity levels pre-operatively. Both groups demonstrated significant improvements in alpha and Wiberg angles post-surgery (p < 0.001). The surgery duration was similar between groups, and no significant differences in post-operative outcomes were found between football and non-football players. Conclusions: Hip arthroscopy is effective for both football and non-football players with FAI, with both groups experiencing significant improvements in hip joint function and pain relief. While pre-operative functional scores differed, particularly in activity levels, both groups benefited from similar post-operative outcomes, suggesting that the surgical approach is suitable for active individuals across different sports. Further research is needed to explore long-term outcomes and return-to-sport rates in these populations.