Abstract：
Staged bilateral hip arthroscopy is an option for athletes who have symptomatic bilateral femoroacetabular impingement; however, the optimal timing of the second procedure is unknown.
To evaluate minimum 2-year outcomes for patients undergoing accelerated bilateral arthroscopy against those undergoing (1) delayed bilateral and (2) unilateral arthroscopy.
Cohort study; Level of evidence, 3.
A retrospective review was performed of prospectively collected data from patients undergoing bilateral primary hip arthroscopy for femoroacetabular impingement between 2009 and 2022. Inclusion criteria entailed competitive athletes with concurrent bilateral symptoms at initial presentation. Exclusion criteria (either hip) were Tönnis grade >1, dysplasia (lateral center-edge angle <25°), Perthes disease, protrusio acetabuli, and avascular necrosis. Two groups were established based on the duration between procedures: within 7 days (accelerated group) and within 4 to 12 weeks (delayed group). Patients from the accelerated group were matched in a 1:2 ratio with patients undergoing unilateral surgery based on age ±2 years, sex, and athletic status. Minimum 2-year postoperative patient-reported outcomes (PROs) (including modified Harris Hip Score, University of California Los Angeles activity scale, 36-Item Short Form Health Survey, and Western Ontario and McMaster Universities Osteoarthritis Index), rates of achieving the minimal clinically important difference, rates of continuing to play main sport, and satisfaction were compared between groups.
A total of 131 athletes (262 hips) with bilateral femoroacetabular impingement were included: 91 in the accelerated group and 40 in the delayed group. Duration between surgeries was 0.99 ± 0.02 and 6.35 ± 2.18 weeks, respectively. All accelerated athletes were each successfully matched to 2 athletes with unilateral procedures (N = 182). All 3 groups demonstrated significant improvement from baseline across all PROs (P < .001 for all). Acquired change in PROs was similar and not significantly different between groups (P > .05). Satisfaction with relief from pain was achieved by 85.9% of patients in the accelerated group compared with 83.1% in the delayed group (P = .053) and 87.3% in the unilateral group (P = .933). The minimal clinically important difference for the modified Harris Hip Score was achieved by 84.9% of patients in the accelerated group compared with 91.5% in the delayed group (P = .212) and 87.6% in the unilateral group (P = .456). At 2 years postoperatively, the continue-to-play rate was 73.6% for the accelerated group compared with 77.1% for the delayed group (P = .577) and 73.0% for the unilateral group (P = .903). There were no increased complications associated with the accelerated group.
Accelerated bilateral hip arthroscopy 1 week apart was a safe and effective treatment option for athletes with bilateral symptoms. Improvement in PROs and continue-to-play rates were comparable with those after a delayed duration between procedures and with those case-control matched athletes undergoing unilateral arthroscopy.
To evaluate minimum 2-year outcomes for patients undergoing accelerated bilateral arthroscopy against those undergoing (1) delayed bilateral and (2) unilateral arthroscopy.
Cohort study; Level of evidence, 3.
A retrospective review was performed of prospectively collected data from patients undergoing bilateral primary hip arthroscopy for femoroacetabular impingement between 2009 and 2022. Inclusion criteria entailed competitive athletes with concurrent bilateral symptoms at initial presentation. Exclusion criteria (either hip) were Tönnis grade >1, dysplasia (lateral center-edge angle <25°), Perthes disease, protrusio acetabuli, and avascular necrosis. Two groups were established based on the duration between procedures: within 7 days (accelerated group) and within 4 to 12 weeks (delayed group). Patients from the accelerated group were matched in a 1:2 ratio with patients undergoing unilateral surgery based on age ±2 years, sex, and athletic status. Minimum 2-year postoperative patient-reported outcomes (PROs) (including modified Harris Hip Score, University of California Los Angeles activity scale, 36-Item Short Form Health Survey, and Western Ontario and McMaster Universities Osteoarthritis Index), rates of achieving the minimal clinically important difference, rates of continuing to play main sport, and satisfaction were compared between groups.
A total of 131 athletes (262 hips) with bilateral femoroacetabular impingement were included: 91 in the accelerated group and 40 in the delayed group. Duration between surgeries was 0.99 ± 0.02 and 6.35 ± 2.18 weeks, respectively. All accelerated athletes were each successfully matched to 2 athletes with unilateral procedures (N = 182). All 3 groups demonstrated significant improvement from baseline across all PROs (P < .001 for all). Acquired change in PROs was similar and not significantly different between groups (P > .05). Satisfaction with relief from pain was achieved by 85.9% of patients in the accelerated group compared with 83.1% in the delayed group (P = .053) and 87.3% in the unilateral group (P = .933). The minimal clinically important difference for the modified Harris Hip Score was achieved by 84.9% of patients in the accelerated group compared with 91.5% in the delayed group (P = .212) and 87.6% in the unilateral group (P = .456). At 2 years postoperatively, the continue-to-play rate was 73.6% for the accelerated group compared with 77.1% for the delayed group (P = .577) and 73.0% for the unilateral group (P = .903). There were no increased complications associated with the accelerated group.
Accelerated bilateral hip arthroscopy 1 week apart was a safe and effective treatment option for athletes with bilateral symptoms. Improvement in PROs and continue-to-play rates were comparable with those after a delayed duration between procedures and with those case-control matched athletes undergoing unilateral arthroscopy.
摘要：
■对于有症状的双侧股骨髋臼撞击的运动员，分期双侧髋关节镜检查是一种选择；然而，第二个过程的最佳时机是未知的。
■评估加速双侧关节镜检查患者与（1）延迟双侧和（2）单侧关节镜检查患者的最低2年结局。
■队列研究；证据水平，3.
■对2009年至2022年间接受双侧初次髋关节镜检查股骨髋臼撞击的患者的前瞻性数据进行了回顾性审查。纳入标准要求竞技运动员在初次就诊时同时出现双侧症状。排除标准（任一髋关节）为Tönnnis等级>1，发育不良（外侧中心边缘角度<25°），Perthes病,前髋臼,血管坏死.根据程序之间的持续时间建立两组：7天内（加速组）和4至12周内（延迟组）。根据年龄±2岁，加速组的患者与接受单侧手术的患者以1：2的比例匹配，性别,和运动状态。术后至少2年患者报告结果（PRO）（包括改良Harris髋关节评分，加州大学洛杉矶分校的活动规模，36项简式健康调查，和西安大略省和麦克马斯特大学骨关节炎指数)，达到最小临床重要差异的比率，继续从事主要运动的比率，组间比较满意度。
■共包括131名双侧股骨髋臼撞击的运动员（262髋）：加速组91名，延迟组40名。手术间隔为0.99±0.02和6.35±2.18周，分别。所有加速运动员均与2名单侧手术运动员成功匹配（N=182）。所有3组均显示出相对于基线的显着改善（所有P<.001）。获得的PRO变化相似，组间无显著差异(P>.05)。加速组患者对疼痛缓解的满意度为85.9％，延迟组患者为83.1％（P=0.053），单侧组患者为87.3％（P=.933）。改良Harris髋关节评分的最小临床重要差异在加速组中达到84.9%，而在延迟组中达到91.5%（P=0.212），在单侧组中达到87.6%（P=0.456）。术后2年，加速组的继续播放率为73.6%,延迟组为77.1%(P=.577),单侧组为73.0%(P=.903).加速组的并发症没有增加。
■对于有双侧症状的运动员，间隔1周加速双侧髋关节镜检查是一种安全有效的治疗选择。PRO和继续比赛率的改善与手术之间的持续时间延迟后的情况以及接受单侧关节镜检查的病例对照匹配运动员相当。
■评估加速双侧关节镜检查患者与（1）延迟双侧和（2）单侧关节镜检查患者的最低2年结局。
■队列研究；证据水平，3.
■对2009年至2022年间接受双侧初次髋关节镜检查股骨髋臼撞击的患者的前瞻性数据进行了回顾性审查。纳入标准要求竞技运动员在初次就诊时同时出现双侧症状。排除标准（任一髋关节）为Tönnnis等级>1，发育不良（外侧中心边缘角度<25°），Perthes病,前髋臼,血管坏死.根据程序之间的持续时间建立两组：7天内（加速组）和4至12周内（延迟组）。根据年龄±2岁，加速组的患者与接受单侧手术的患者以1：2的比例匹配，性别,和运动状态。术后至少2年患者报告结果（PRO）（包括改良Harris髋关节评分，加州大学洛杉矶分校的活动规模，36项简式健康调查，和西安大略省和麦克马斯特大学骨关节炎指数)，达到最小临床重要差异的比率，继续从事主要运动的比率，组间比较满意度。
■共包括131名双侧股骨髋臼撞击的运动员（262髋）：加速组91名，延迟组40名。手术间隔为0.99±0.02和6.35±2.18周，分别。所有加速运动员均与2名单侧手术运动员成功匹配（N=182）。所有3组均显示出相对于基线的显着改善（所有P<.001）。获得的PRO变化相似，组间无显著差异(P>.05)。加速组患者对疼痛缓解的满意度为85.9％，延迟组患者为83.1％（P=0.053），单侧组患者为87.3％（P=.933）。改良Harris髋关节评分的最小临床重要差异在加速组中达到84.9%，而在延迟组中达到91.5%（P=0.212），在单侧组中达到87.6%（P=0.456）。术后2年，加速组的继续播放率为73.6%,延迟组为77.1%(P=.577),单侧组为73.0%(P=.903).加速组的并发症没有增加。
■对于有双侧症状的运动员，间隔1周加速双侧髋关节镜检查是一种安全有效的治疗选择。PRO和继续比赛率的改善与手术之间的持续时间延迟后的情况以及接受单侧关节镜检查的病例对照匹配运动员相当。
