High Rate of Return to Sport in Competitive Athletes Undergoing Periacetabular Osteotomy With Concomitant Hip Arthroscopy

PURPOSE: To report the return-to-sport rate of competitive athletes with hip dysplasia, in relation to their preoperative level of competition, who underwent hip arthroscopy with concomitant periacetabular osteotomy (HA + PAO). METHODS: Patients participating in competitive sports who underwent HA + PAO for the correction of hip dysplasia between January 2016 and December 2023 by a single orthopaedic surgeon were retrospectively reviewed. Patients who underwent periacetabular osteotomy-alone or were classified as participating in recreational sports were excluded. Patients without documentation of attempted RTS or interest in RTS were also excluded. Pre- and postoperative level and type of sport were assessed. Sport level was categorized as high school, competitive club (regional, national, or international competition), college, and/or professional level. The level of RTS was classified as lower, same, or higher than preoperative status. A minimum 2-year follow-up was attempted for all patients. RESULTS: Forty-eight patients (56 hips) were identified. Four patients were lost to follow-up. Forty-four patients (37 women, 7 men) and 52 hips were included in the analysis. Eight patients underwent bilateral HA + PAO. Athletes from high school (n = 16), high school and competitive club (n = 6), competitive club (n = 12), college (n = 9), and professional (n = 1) levels were included. Of the 44, 41 returned (93.18%) to sport and 3 did not (6.82%). Of the 41 athletes who returned to sport, 33 (80.49%) returned to their preoperative level, 5 (12.19%) returned to a higher level of competition, and 3 (7.32%) returned to a lower level of competition. Data on subsequent surgeries after HA + PAO were available for 88.63% (39/44) of patients, with a minimum 2-year follow-up and a mean follow-up duration of 47.78 months (range = 24-120 months). Three patients sustained complications that required a return to the operating room. CONCLUSIONS: This study reported an overall RTS rate of 93.1% in competitive athletes who underwent an HA + PAO, with an 86.36% (38/44) rate of return to the same or higher level of competition. LEVEL OF EVIDENCE: Level IV, retrospective case series.