Purpose: To investigate the return to sport (RTS) rate and the sex-based difference of collegiate athletes after arthroscopic treatment for femoroacetabular impingement (FAI).
Methods: Patients who were collegiate athletes at the time of surgery and underwent hip arthroscopy for treatment of FAI between January 2009 and June 2020 were included. Patients were excluded if they were in their final year of eligibility, graduated, retired, or had plans to retire from collegiate play before surgery. Publicly available data were collected regarding each patient's collegiate team and division and RTS status after surgery. Comparisons were made based on the RTS status and gender.
Results: Of the 181 hips (144 athletes) who met the inclusion criteria, 114 were male (63%) and 67 were female (37%), with a median age of 20.4 (range: 18.0-24.5). Eighty-six percent (155 hips) returned to sport at the collegiate level after hip arthroscopy. Males were significantly less likely to return to sport compared with females (82% vs 93%, odds ratio = 2.8, 95% confidence interval: 1.003-7.819, P = .042). Males participated in more contact sports (26% vs 1.5%, P < .001) and had more mixed-type FAI (95.6% vs 80.6%, P = .003) compared with females. In addition, males had more grade 3/4 chondral defects (28% vs 13%, P = .023) and underwent microfracture more frequently (11% vs 3%, P = .047). Further, males had significantly larger postoperative alpha angles (46.2 vs 43.6, P < .001).
Conclusions: Collegiate athletes were found to have a high RTS rate of 86% after arthroscopy for the treatment of FAI; however, males were less likely to RTS compared with females. Sex-based differences were identified in the type of sports, type of FAI, prevalence of severe cartilage damage, and postoperative alpha angle.
Level Of Evidence: Level IV, retrospective case series.
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