Patient reported outcomes and return to play after arthroscopic hip labral reconstruction in athletes: a systematic review and meta-analysis

Femoroacetabular impingement is a common cause of labral damage and hip pain in athletes. In severe labral tears with inadequate healthy labrum for repair, labral reconstruction has shown positive clinical outcomes in the general population. This study aimed to conduct a systematic review and meta-analysis on athletes undergoing arthroscopic hip labral reconstruction, focusing on postoperative patient-reported outcomes (PROs) and return to play (RTP). A systematic review of the literature was performed to include studies reporting PROs of labral reconstruction in athletes across multiple databases. Of the initial 430 identified records, four satisfied inclusion criteria of reporting PROs at 1-year minimum follow-up and RTP. Athletes included recreational through professional levels. Three studies analyzed return to same level of play (RTSP). Meta-analysis was conducted by pooling data, creating forest plots, and reporting odds ratios (OR). The four studies included 126 hips with average age at surgery of 32.2 years. All PROs in each study showed significant improvements with postoperative pooled weighted improvements in modified Harris Hip Score by 18.9 (Cohen’s d = 1.10), Non-arthritic Hip Score by 19.6 (Cohen’s d = 1.10), Hip Outcome Score-Sport by 25.6 (Cohen’s d = 1.15), and Visual Analogue Scale-Pain by −3.0 (Cohen’s d = −1.81). RTP averaged 81.4%, ranging from 73.3% to 90.0%. RTSP ranged from 40.6% to 81.0% with an overall OR of 83 (I²= 0.00). This meta-analysis found excellent patient-reported clinical outcomes at 1-year minimum follow-up after labral reconstruction in athletes, and a return-to-play rate of 81.4%. These data can help counsel athletes who undergo arthroscopic hip labral reconstruction.