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Simultaneous Bilateral Hip Arthroscopy in Adolescent Athletes With Symptomatic Femoroacetabular Impingement

McConkey, Mark O., MD*; Chadayammuri, Vivek, BS; Garabekyan, Tigran, MD; Mayer, Stephanie W., MD§; Kraeutler, Matthew J., MD; Mei-Dan, Omer, MD

Journal of Pediatric Orthopaedics: April 2019 - Volume 39 - Issue 4 - p 193–197
doi: 10.1097/BPO.0000000000000987
Sports Medicine
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Background: Femoroacetabular impingement represents a common cause of hip pain in adolescents. The purpose of the present study was to evaluate the safety and efficacy of simultaneous bilateral hip arthroscopy for bilateral symptomatic femoroacetabular impingement in adolescent athletes.

Methods: Clinical data were collected in a prospective database on patients who underwent unilateral or simultaneous bilateral hip arthroscopy and included complications, reoperation rate, and return to play time. Differences in International Hip Outcome Tool (iHOT)-12 scores according to hip side and postoperative follow-up time (preoperative, 1.5, 3, 6, 12, and 24 mo) were evaluated using a 2×6 repeated-measures analysis of variance with post hoc repeated-measures 1-way analysis of variance and Bonferroni-corrected paired t tests.

Results: In total, 24 patients (36 hips) were studied, of whom 12 underwent simultaneous bilateral hip arthroscopy (24 hips) and a case-matched control group of 12 patients underwent unilateral hip arthroscopy. There were 5 males in each group (41.7%). Average age was 15.7 and 16.5 years in the bilateral and unilateral groups, respectively. No patients were lost to follow-up. In the bilateral group, a significant increase in mean iHOT-12 score was observed between 1.5- and 3-month follow-up (61.8 vs. 82.8, respectively; P=0.003), and 6-, 12-, and 24-month follow-up (91.4, 95.1, and 96.6, respectively, P=0.004). At all follow-up times, there were no significant differences in mean iHOT-12 scores or other outcome measures between bilateral and unilateral cohorts. Time to return to preinjury level of activity was similar between the bilateral and unilateral groups (4.7 vs. 4.9 mo, respectively; P=0.40). One transient lateral femoral cutaneous nerve palsy occurred in each group, though no other complications were documented. No patients required revision surgery by latest follow-up.

Conclusions: Bilateral simultaneous hip arthroscopy is safe and reproducible in adolescent athletes, achieving equivalent outcomes, and similar rehabilitation time when compared with unilateral surgery.

Level of Evidence: Level II—therapeutic study.

*Pacific Orthopedics and Sports Medicine, North Vancouver, BC

Department of Orthopedics, University of Colorado School of Medicine

§Children’s Hospital Colorado, Aurora, CO

Southern California Hip Institute, North Hollywood, CA

M.O.M.: assisted in development of study idea, wrote majority of manuscript. V.C.: performed statistical analysis, critical revision of manuscript. T.G. and S.W.M.: assisted in development of study idea, critical revision of manuscript. M.J.K.: wrote portions of manuscript, critical revision of manuscript. O.M.-D.: assisted in development of study idea, enrolled patients, supervised study, critical revision of manuscript.

Source of funding: none.

The authors declare no conflicts of interest.

Reprints: Omer Mei-Dan, MD, University of Colorado School of Medicine, Department of Orthopedics, 12631 E 17th Avenue, Mail Stop B202, Room L15-4505, Aurora, CO 80045. E-mail: omer-meidan@ucdenver.edu.

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