Hip Arthroscopic Labral Repair for Femoroacetabular Impingement Yields High Return‐to‐Sport Rates and Improved Outcomes in Basketball Players

PURPOSE: To evaluate return-to-sport (RTS) rates and patient-reported outcome measures (PROMs) following hip arthroscopic labral repair for femoroacetabular impingement in active basketball players with a minimum of 2-year follow-up. METHODS: All patients who were active basketball players and underwent hip arthroscopy with labral repair for femoroacetabular impingement from 2009 to 2022 were identified. Patients were evaluated for postoperative RTS and revision surgery at a minimum 2-year follow-up. RTS was defined as resuming basketball participation, at any level. Modified Harris Hip Score (mHHS), Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Sport (HOS-Sport), and surgery satisfaction were also collected. RESULTS: Sixty-seven hips in 54 athletes (29 male, 25 female) with a mean age of 22.2 years (range 13-39 years) were included. Eighty-six (86%) were recreational or high school basketball players. There was significant improvement in all PROMs from baseline to a minimum 2-year follow-up (all P < .001). After excluding for athletes who did not RTS for nonmedical reasons, 78% of athletes returned to basketball following hip arthroscopy. Including patients who cited nonmedical reasons for not returning, the overall RTS rate was 65%. Athletes who RTS had significantly higher mHHS (P = .012), HOS-ADL (P = .006), and HOS-Sport (P = .002), as well as lower visual analog scale pain (2.2 vs 3.4, P = .037) than those who did not RTS. Calculated minimal clinically important difference values were 8.3 for mHHS, 7.2 for HOS-ADL, and 13.4 for HOS-Sport. Anchor-based patient acceptable symptom state calculations yielded thresholds of 83.5 for mHHS, 92.6 for HOS-ADL, and 79.2 for HOS-Sport-with 70%, 63%, and 67% of patients achieving these thresholds, respectively. CONCLUSIONS: Basketball players who undergo hip arthroscopic labral repair for femoroacetabular impingement show significant improvements in PROMs with 78% RTS rate at a minimum 2-year follow-up. Although many athletes discontinued basketball for reasons unrelated to the hip, 18% cited hip issues. Basketball players who successfully return to basketball report higher PROMs than nonreturners, and cohort-specific minimal clinically important difference analysis indicates that most athletes achieve clinically meaningful improvements. LEVEL OF EVIDENCE: Level IV, therapeutic retrospective case series.