Endoscopic Pubic Symphysectomy for Refractory Osteitis Pubis Provides Positive Functional Outcomes and High Return‐to‐Sport Rate at a Minimum 2‐Year Follow‐Up

PURPOSE: To evaluate the outcomes of endoscopic pubic symphysectomy as a treatment for refractory osteitis pubis with a minimum 2-year follow-up, and to present a return-to-sport (RTS) subanalysis of this patient population. METHODS: Prospectively collected data were retrospectively analyzed for patients who underwent endoscopic pubic symphysectomy as treatment for osteitis pubis between May 2012 and September 2021. Included patients had completed preoperative and a minimum of 2-year postoperative questionnaires for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports-Specific Subscale, International Hip Outcome Tool (iHOT-12), visual analog scale, and patient satisfaction. The minimal clinically important difference was calculated for the mentioned patient-reported outcomes and included in the analysis. For the subanalysis, sport participation was defined as participation within 1 year of surgery, and RTS rates were calculated for the overall cohort and for the subset of patients who attempted to return postoperatively. RESULTS: A total of 14 (93.3%) out of 15 patients were included in the study. All patients experienced symptom relief with a significant improvement in mHHS (P < .05), NAHS (P < .05), iHOT-12 (P < .01), and a high patient satisfaction rate with a mean satisfaction of 8.5 ± 2.7. A high percentage of patients reached the calculated minimal clinically important difference for mHHS, NAHS, Hip Outcome Score-Sports-Specific Subscale, and iHOT-12. Twelve patients (85.7%) reported sports participation. The overall RTS rate was 75%. Of the 9 patients who attempted to return, all (100%) successfully resumed sport within 1 year postoperatively, while 3 (25%) patients chose not to attempt RTS due to a desire to prevent symptoms. CONCLUSIONS: Endoscopic pubic symphysectomy for refractory cases of osteitis pubis yielded significant improvement in mHHS, NAHS, iHOT-12, and a high patient satisfaction, reaching clinical important thresholds at a high rate at a minimum 2-year follow-up. All patients who attempted to return to sport were able to return to sport participation within 1 year of the surgery. LEVEL OF EVIDENCE: Level IV, retrospective case series.