Hip Arthroscopy Yields Favorable Outcome, Return‐to‐Sport Rate, and 5‐Year Survivorship in Athletic Population With Generalized Ligamentous Laxity in the Treatment of Femoroacetabular Impingement and Labral Tears

Purpose To evaluate the minimum 5‐year clinical outcomes and return‐to‐sport (RTS) rates of patients with generalized ligamentous laxity (GLL) who underwent hip arthroscopy with a secondary comparison to a benchmark control group with no GLL. Methods We retrospectively analyzed all patients with GLL (Beighton score ≥ 4) who underwent primary hip arthroscopy between November 2009 and January 2019. We included patients who reported preoperative sport participation and had preoperative and minimum 5‐year follow‐up for at least one patient‐reported outcome (PRO) measure: modified Harris Hip Score (mHHS), Non‐Arthritic Hip Score (NAHS), Hip Outcome Score Sport‐Specific Subscale (HOS‐SSS), International Hip Outcome Tool‐12 (iHOT‐12), or Visual Analog Scale (VAS) for pain. Revision hip arthroscopy or conversion to arthroplasty was accounted for. Patients with GLL were matched to patients with a Beighton score of <3. Rates of meeting the minimal clinically important difference (MCID), RTS, and having secondary surgery were analyzed. Results Two hundred thirty‐two hips were included, with 116 hips in the GLL group (age: 27.3 years, BMI: 23.7 kg/m 2 ) (78.7% follow‐up) and 116 in the control group (age: 28.4 years, BMI: 23.6 kg/m 2 ). Patients in the GLL group showed significant improvement in all evaluated PROs (mHHS: 66.1‐86.7, NAHS: 67.6‐87.0, iHOT‐12: 40.1‐78.2, HOS‐SSS: 45.0‐79.7, VAS: 4.9‐2.1; P < .01). MCID was met at similarly high rates for both groups ( P > .05). Patients with GLL reported a RTS rate of 83% at any time point postoperative, and 74.6% of those that returned were able to continue playing at the 5‐year mark. No differences in postoperative PRO scores, RTS, continuation‐of‐sport participation, and survivorship were found between groups. Conclusions Hip arthroscopy in patients with GLL yields favorable outcomes and survivorship at 5‐year minimum follow‐up comparable to patients without GLL. A high percentage of athletes with GLL were able to RTS and continue playing 5 years after hip arthroscopy. Level of Evidence Level IV, retrospective comparative case series.