ePoster #1503 - ISHA Annual Scientific Meeting 2016

Patterns of Sports Participation in Adolescents Requiring Arthroscopic Hip Preservation: Does Sport Type Matter?

John Christoforetti, MD, Pittsburgh, PA UNITED STATES
Andrew B. Wolff, MD, Washington, DC UNITED STATES
Shane J. Nho, MD, MS, Chicago, IL UNITED STATES
John P. Salvo, MD, Marlton, NJ UNITED STATES
Thomas J. Ellis, MD, Columbus, Ohio UNITED STATES
Dean K. Matsuda, MD, Los Angeles, CA UNITED STATES
Ryan McGovern, ATC, Pittsburgh, PA UNITED STATES
Allston J. Stubbs, MD, MBA, Winston Salem, NC UNITED STATES
Benjamin Kivlan, PhD, Pittsburgh, PA UNITED STATES
Dominic Carreira, MD, Fort Lauderdale, FL UNITED STATES

Allegheny Clinic, Pittsburgh, PA, UNITED STATES

FDA Status Not Applicable

Summary: Cross sectional cohort analysis of adolescents undergoing hip arthroscopy shows significant proportion of participants in cutting, jumping or pivoting sports but no correlation with number of sports played.

Abstract:
Adolescents have been increasing victims of hip injury requiring arthroscopic or open hip preserving surgery. Several centers have demonstrated the safety and efficacy of hip preserving surgery for this patient group with high reported return to sport rates in small groups of adolescent patients. There is no current understanding of the relative risk for surgical hip injury for adolescents participating in common world sports. A multi-center registry database of prospectively collected hip arthroscopic surgery cases was used to perform a cross-sectional cohort study to determine the compatibility of stratification of injury prevalence by sport level for adolescent patients requiring surgery. Our hypothesis was sports with highest amounts of lateral cutting motions and contact risk (Level I) are highest risk while non-contact, linear motion sports are lowest risk (Level III). Methods: A multi-center hip arthroscopy study group comprised of Board Certified surgeon members in the United States with greater than 300 cases completed prior to enrollment and with annual case volumes greater than 100 cases per year was created. Institutional Review Board approval for pre-hoc collection and storage of agreed upon de-identified clinical data points was granted at each center. The de-identified data set was retrospectively reviewed and analyzed. All male and female adolescents who elected to have hip preservation surgery due to hip pain that prevented participation in sports were identified and grouped based upon risk category for ACL injury (Level 1-3). A retrospective data analysis from a multi-center hip arthroscopy registry examined the incidence of adolescent athletes (age less than 20 years) undergoing hip preservation surgery. Chi Square Analysis with an a priori alpha set at p<0.05 was performed to determine the relationships of classification of sport and number of sports the athlete was participating in to hip preservation surgery. Results: The retrospective analysis included 140 patients (95 female; 45 male) that were participating in sports at a recreational, high school, or collegiate level. A chi-square test showed a significant relationship between sport classification and hip preservation surgery, X2 (2, N = 140) = 46.34, p<0.001. There were 45.7% of adolescent athletes electing to have hip preservation surgery that were participating in Level 1 sports (jumping, cutting, pivoting) compared to 30.7% participating in Level 2 sports (lateral movements, less pivoting) and 23.6% participating in Level 3 sport activities (straight ahead activities). There was a slightly greater percentage of athletes that participated in multiple sports (56.4%) compared to athletes that participated in only in a single sport (43.6%) but was not statistically significant, X2 (2, N = 140) = 0.021, p=0.87. Conclusions: In this large multi-center cohort of adolescent athletes requiring arthroscopic hip preservation surgery, sports most commonly associated with highest risk for ACL injury (level 1) were most commonly represented. Multi-sport participation was not significantly different from single sport participation in this group. This information may be used to guide further study and in counseling parents concerning injury risks for sports participation in the adolescent.