Predictors of Length of Career Following Hip Arthroscopy for Femoroacetabular Impingement in Professional Hockey Players

OBJECTIVES: Previous studies have shown that professional hockey players return to sport at a high rate following hip arthroscopy. The average length of a National Hockey League (NHL) career has been reported to be 5.5 years, and it is unknown how long players continue to play after hip arthroscopy. The purpose of this study was 1) to determine predictors of length of career in players following hip arthroscopy for treatment of symptomatic femoroacetabular impingement (FAI), and 2) investigate the rate of those who continue to play professional hockey a minimum of 5 years after hip arthroscopy. METHODS: Seventy professional hockey players underwent hip arthroscopy for FAI between 2005 and 2010 by a single surgeon. Data was retrieved from NHL.com regarding the duration of each player’s professional career. In addition, position played, draft position, age at time of surgery, and surgical details were also used in data analysis. RESULTS: Our cohort included thirteen players that were centers, 15 defensemen, 20 goalies, and 22 wings. The average overall draft number was 57 (range 1 to 228), and average age at surgery was 27 years (range 17 to 38). Forty of the 70 athletes (57%) continued to play professionally a minimum of 5 years after hip arthroscopy. As of the most recent 2015 season, the average NHL length of career was 13 years (range 8 to 23 years), with an average of 6.9 years played following hip arthroscopy. Therre was no different in length of career and years played when goalies were compared to other players(p=0.760). Length of career and years played after arthroscopy correlated with age at surgery (r=0.799 and r=-0.408). Players who played 5 or more years after arthroscopy were significantly younger than those who did not (25 vs. 30 years, p=0.001). Sixty-five players (93%) had labral repair and 5 (7%) had labral reconstruction. There were no differences in length of career or years played after arthroscopy based on type of labral treatment (p=0.278). Ten patients (14%) additionally underwent microfracture of the acetabulum for chondral damage, and no players required microfracture of the femoral head. Players who had microfracture were older (31 vs 26 years, p=0.007) and had longer careers (17 vs. 13 years, p=0.036). There was no difference in years played after surgery between the microfracture group and those who did not have microfracture (5 vs 4.9 years, p=0.854). Multiple regression analysis showed the only independent predictor of years played after arthroscopy was age (r2=0.232, p=0.001). CONCLUSION: Professional NHL players who underwent hip arthroscopy for FAI were able to continue playing at an elite level for an average of 6.9 years following surgery, with 57% playing a minimum of 5 years postoperatively. Younger age at time of surgery correlated with greater length of career and years played after hip arthroscopy. Type of labral treatment (repair vs. reconstruction) and presence of acetabular chondral damage requiring microfracture did not significantly impact length of career or years played postoperatively. Our data supports early arthroscopic treatment of professional hockey players with symptomatic FAI.