Athletes Undergoing Staged Bilateral Hip Arthroscopy Show Favorable Midterm Outcomes and Return to Sport: A Propensity‐Matched Study

PURPOSE: To evaluate midterm patient-reported outcomes (PROs) and rates of return to sports of bilateral primary hip arthroscopy in high-level athletic populations with minimum 5-year follow-up and to compare outcomes with a propensity-matched control group of high-level athletic populations undergoing unilateral primary hip arthroscopy. METHODS: Data were analyzed for high-level athletic populations (high school, college, or professional) who underwent bilateral hip arthroscopy between July 2009 and January 2019. Patients were included if they had at least one of these PROs at minimum 5-year follow-up: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score, International Hip Outcome Tool-12, Hip Outcome Score-Sports Specific Subscale, and Visual Analog Scale for pain. Patients were matched 1:1 to unilateral athletes. Rates of achieving the minimal clinically important difference, patient acceptable symptomatic state, and substantial clinical benefit were compared. RESULTS: Forty-six bilateral athletes were matched to 46 unilateral athletes. The mean follow-up of the bilateral group (second side) is 90.1 ± 28.8 (60.0-130.2) months and 91.4 ± 30.9 (12.3-136.7) for the unilateral group. All groups showed significant PRO improvement. 84.4% of the bilateral first side achieved mHHS minimal clinically important difference, 78.3% of the second side, and 83.3% of the unilateral group (P = .716). 73.3% of the bilateral first side achieved mHHS patient acceptable symptomatic state, 78.3% of the second side, and 85.7% of the unilateral group (P = .364). 57.8% of the bilateral first side achieved mHHS substantial clinical benefit, 60.9% of the bilateral second side, and 76.2% of the unilateral group (P = .160). Bilateral and unilateral athletes returned to sport at a high rate (88.6% and 85.0%). 80.0% of unilateral and 68.8% of bilateral athletes were playing their sport at minimum 5-year follow-up (P = .31). Seven (15.2%) unilateral athletes underwent ipsilateral secondary arthroscopy. Seven bilateral first side patients (15.2%) and 1 bilateral second side patient (2.2%) underwent ipsilateral secondary arthroscopy. CONCLUSIONS: Athletes undergoing staged bilateral hip arthroscopy showed favorable return to sports rates, continuation of sports and PROs at minimum 5-year follow-up. These results were comparable with the matched benchmark control group who underwent unilateral hip arthroscopy. LEVEL OF EVIDENCE: Level III, retrospective comparative case series.