FP4.6 Psychological Readiness to Return to Sport following Hip Arthroscopy for Femoroacetabular Impingement

Background: Femoroacetabular impingement syndrome (FAIS) often affects athletes who participate in high impact activities and can be treated with hip arthroscopy. Returning to sport (RTS) is a common postoperative expectation and depends on both physical and psychological readiness. The Hip-Return to Sport after Injury (Hip-RSI) is a validated tool used to assess an athlete’s psychological readiness to RTS, and specifically evaluates the constructs of emotions, confidence in performance, and risk appraisal. Psychological readiness to RTS at different stages of recovery following hip arthroscopy for FAI has not yet been described. The purpose of this study was to assess Hip-RSI in physically active patients at 3, 6, and 12-months after hip arthroscopy.

Methods: This was a retrospective study on prospectively collected data from a single-surgeon hip registry. Patients who underwent hip arthroscopy and completed the Hip-RSI at minimum one postoperative time point from June 2021-December 2023 were identified. Chart review was conducted to obtain demographics. Those who were not physically active before surgery were excluded. Participants were then allotted into the 3, 6, and/or 12 month group based on completion of Hip-RSI. Descriptive statistics were calculated at each time point. A one-way analysis of variance (ANOVA) was performed to identify differences between Hip-RSI scores between the 3, 6, and 12-months groups.

Results: Seventy-six patients met inclusion criteria (3-month cohort N=47, average age 25.61±12.79; 6-month cohort N=37, average age 25.67±11.92; 12-month cohort N=25, average age 24.3±11.55). Hip-RSI total scores were significantly higher in the 12-month group compared to 3-month (75.73±25.19 vs. 52.24±25.5, p = 0.001) and 6-month groups (75.73±25.19 vs. 52.87±28.72, p = 0.002). A similar trend was found when assessing questions pertaining to emotions and confidence, with the 12-month group being significantly higher than the 3-month (74.23±26.89 vs. 48.31±24.52, p<0.001 and 76.44±24.88 vs. 53.07±21.17, p=0.004, respectively) and 6-month (74.23±26.89 vs. 48.90±30.77, p=0.001 and 76.44±24.88 vs. 23.66±32.77, p=0.008). However, no differences in risk appraisal were observed between 3, 6, and 12-month groups.

Conclusion: Psychological readiness to RTS was significantly higher at 12-months than at 3 or 6-months after hip arthroscopy for symptomatic FAIS. Our results suggest that psychological recovery may develop on a timeline independent of physical recovery. This highlights an opportunity for clinicians to monitor psychological readiness throughout the recovery process in order to maximize patients’ ability to successfully RTS.