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formed. (D) Occluding the inflow of fluid confirms vascular access through the areas of perforation. The athlete was maintained on a protected weight-bearing status emphasizing range of motion for 10 weeks, with return to competition at 3.5 months.

importance among athletes is how quickly they will recover. According to the same study, the greatest improvement (67%) was noted after the first month. Maximal improvement was achieved by 3 months, and these results were maintained among those athletes with 5-year follow-up (Figure 13.8).

Among athletes, the best results have been seen for impinging osteophytes, loose bodies, and rupture of the ligamentum teres (Figure 13.9). Impinging os-teophytes are uncommon, but when recognized, the structural problem can be corrected, thus often resulting in pronounced symptomatic improvement. Loose bodies have traditionally been recognized as the clearest indication for arthroscopy. Predictable results have been further confirmed in the athletic population. Rupture of the ligamentum teres is an entity that has infrequently been reported in the literature. A propensity for this injury has been identified among athletes, being the third leading diagnosis, and it responds remarkably well to arthroscopic debridement. More average results have been reported for labral tearing and chondral injury. The results are poor in the presence of clinical evidence of arthritis, but those patients undergoing microfracture fared better than with simple chondroplasty.

The nature of the onset of symptoms seems at least partially to influence the results. Those with a specific history of a significant traumatic event fared the best (Figure 13.10), whereas those with insidious onset did the worst. Those of acute onset fared only slightly better than insidious, which suggests that, even in the presence of a modest explainable injury, some type of predisposition should be suspected and the results of arthroscopy may be less certain.

Among the reported group of athletes, one-third competed at the collegiate, elite, or professional

Months

FIGURE 13.8. Average modified Harris hip scores among athletes at various intervals of follow-up.

FIGURE 13.10. Results based on the onset of symptoms. (From Byrd and Jones,5 with permission of Clin Sports Med.)

Months

FIGURE 13.8. Average modified Harris hip scores among athletes at various intervals of follow-up.

level (Figure 13.11). These groups had a higher baseline preoperative score than the recreational and high school athletes. This finding suggests that these athletes are functioning near the physiologic limits of the body and at a level at which small deficits may significantly influence the athlete's performance.

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