The Influence of Athlete-Specific Factors on Time to Return to Sport Clearance Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome in Division I Collegiate Athletes

Background: High-level athletes who undergo hip arthroscopy for femoroacetabular impingement syndrome (FAIS) return to sport (RTS) at a high rate. However, the influence of athlete-specific factors, including sport, sex, and clinical and surgical findings, on the time to RTS remains unclear. Purpose: To determine if the time to RTS clearance is influenced by sport and sex in collegiate athletes following hip arthroscopy, as well as determine if the time to RTS is impacted by clinical and surgical factors. Study Design: Cohort study; Level of evidence, 2. Methods: In total, 62 Division I collegiate athletes (26 female; 89 hips) who underwent hip arthroscopy for FAIS between January 2017 and July 2024 were included in this analysis of routinely collected health and performance data. Demographic information included sport, sex, age, body mass index, and whether unilateral or staged bilateral hip arthroscopy was performed. Preoperative and intraoperative findings included radiographic measures of hip morphology, the number of anchors used during labral repair, and chondral injury grade. RTS clearance was defined as the date of clearance from a member of the medical team for return to full activity. Time-to-event analyses examined the relationship between time to RTS clearance and athlete-specific factors. Results: There were significant differences in time to RTS clearance among different sports ( P = .002). Athletes in track (median [IQR]: 3.4 [3.2-4.2] months) and wrestling (3.8 [3.2-3.9] months) required less time to RTS clearance than athletes in football (4.9 [4.4-5.4] months; P = .003 and P = .04, respectively). No significant difference was identified between female (4.2 [3.5-5.6] months) and male (4.8 [3.6-5.5] months) athletes regarding median time to RTS clearance (hazard ratio, 0.91; 95% CI, 0.51-1.61; P = .74). No clinical or surgical factors significantly impacted time to RTS clearance (all P values >.05). Conclusion: Collegiate athletes in wrestling and track who undergo hip arthroscopy for FAIS demonstrated quicker time to RTS clearance than those in football. There was no difference in time to RTS clearance between sexes. Despite variations in clinical and surgical factors, no variables within these categories significantly impacted time to RTS clearance.