EP1.61 Clinical outcomes and return to sport following combined hip arthroscopy and peri-acetabular osteotomy for hip dysplasia in high-level athletes

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ID: 331231
2026
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Abstract
Abstract Background Peri-acetabular osteotomy (PAO) is the gold standard treatment for hip dysplasia, with emerging evidence supporting its effectiveness in borderline dysplasia. However, the optimal management of high-level athletes remains debated, particularly whether patients should undergo hip arthroscopy alone or PAO, and whether surgery should occur during peak career or after retirement. Methods A retrospective study of high-level athletes undergoing combined hip arthroscopy and PAO for frank and borderline dysplasia was performed at a single academic institution. The radiographic lateral center-edge angle (LCEA) was used to classify frank (<20°) and borderline (20–25°) dysplasia. Data collection included demographics, type of sport participation, clinical data, time to return to sport (RTS). Patient-reported outcomes (PROs), including the International Hip Outcome Tool (iHOT-12) and the Non-Arthritic Hip Score (NAHS) were collected at preoperative and compared to 1.5, 3, 6, 9, 12, 18, 24, and 60 month timepoints using linear mixed-effects; between-group differences (borderline vs frank) were assessed using independent t-tests with Bonferroni correction. Statistical significance was set to p <0.05. Results A total of 30 patients (50 hips) underwent staged hip arthroscopy and PAO 10 ± 11 days apart. There were 35 hips with frank dysplasia and 15 with borderline dysplasia. The most common sports were dance, running, and soccer, affecting 18, 10, and 8 hips, respectively. Overall, 29 patients (49 hips) successfully RTS after hip arthroscopy and PAO, yielding a 97% patient (98% hip) RTS rate. iHOT-12 and NAHS scores showed significant improvement from preoperative values at 24 months (iHOT-12 48.8, 81.8, p<0.001, n=33; NAHS 65.5, 90.9, p <0.001, n=30) and significant improvement at all other follow-up timepoints after 3 months. There were no significant differences in PROs between the frank and borderline dysplasia groups at any follow-up time point. There were no significant differences in PROs between patients undergoing unilateral vs. bilateral surgery except NAHS at 6 months (95.3 vs. 79.5 respectively, p = .008). Conclusion Combined hip arthroscopy and PAO yields high return-to-sport rates and significant improvements in clinical outcomes in high-level athletes with frank and borderline hip dysplasia.
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Authors Christopher R. Orear, Erel Ben-Ari, Kyle S. J. Jamar, Jessica Lee, James Genuario, Omer Mei-Dan
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.245
URL
https://doi.org/10.1093/jhps/hnag043.245
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