EP1.2 Psychological Readiness of Return to Sport during the First Postoperative Year After Periacetabular Osteotomy with Concomitant Hip Arthroscopy

Background: Periacetabular osteotomy (PAO) is a surgical procedure used to correct developmental dysplasia of the hip (DDH), with concomitant hip arthroscopy being increasingly utilized to correct intra-articular abnormalities. Psychological factors have been shown to influence post-operative outcomes after PAO. However, psychological determinants that impact return to sport (RTS) after a PAO with concomitant hip arthroscopy (scope/PAO) have yet to be investigated. The Hip-Return to Sport after Injury (Hip-RSI) scale is a six-question tool utilized to evaluate psychological readiness for RTS in the post-operative hip preservation population and includes subcategories of emotions, confidence in performance, and risk appraisal. The aim of this study was to examine differences in overall psychological readiness and in these subcategories at 3, 6, and 12 months after a scope/PAO.

Methods: Prospectively collected data was retrospectively reviewed from a single surgeon IRB-approved database. Patients with a diagnosis of DDH who underwent scope/PAO between January 2021 and March 2023 and completed the Hip-RSI at 3, 6, and 12-months postoperatively were included. Patients who had an isolated PAO or did not complete the Hip-RSI at any one of the three timepoints were excluded. A repeated measures analysis of variance was used to compare Hip-RSI scores at 3, 6, and 12-months, as well as for each sub-category of the Hip-RSI. Statistical significance was accepted at an alpha level of 0.05.

Results: Eighteen patients met inclusion criteria (16 female, average age 26.62 ± 8.51, average BMI 24.39 ± 3.84). Hip-RSI was significantly higher at 6 and 12 months compared to 3 months (43.10 ± 23.54 vs. 57.97 ± 0.047, p=0.002 and 43.10 ± 23.54 vs. 70.96 ± 19.16, p=0.002, respectively). In the subcategories of emotions and confidence, there was a significant increase in scores between 3 and 12 months (42.39 ± 26.10 vs. 68.78 ± 21.54, p=0.002 and 41.56 ± 25.21 vs. 67.33 ± 29.76, p=0.006, respectively). There was not a significant difference from 3 to 6 months in the emotions or confidence subcategories. In the risk appraisal subcategory, there was a significant increase between each of the 3 timepoints (3 months: 48.33 ± 29.58; 6 months: 67.33 ± 29.76; 12 months; 79.67 ± 16.96, p<0.001).

Conclusion: Our findings indicate that psychological readiness to RTS after a scope/PAO steadily increases over the first postoperative year. By evaluating psychological readiness after scope/PAO, clinicians can provide a more comprehensive treatment plan that addresses both psychological and physical components of recovery.