EP8.101 Impact of Psychological Factors on Return to Sport in High-Demand Patients Following Hip Arthroscopy

Abstract Introduction Return to sport (RTS) following hip arthroscopy is a critical outcome in high-demand patients; however, clinical recovery does not consistently translate into restoration of pre-symptomatic activity levels. Emerging evidence highlights the influence of psychological factors, including readiness to return to sport and kinesiophobia, on postoperative outcomes. The Hip-Return to Sport after Injury (Hip-RSI) score has been developed to quantify these dimensions, although evidence in the current literature remains limited. The aim of this study was to evaluate the association between psychological factors, functional outcomes, and RTS. Materials and Methods A total of 46 athletic patients (TEGNER ≥5), aged 14–50 years, who underwent hip arthroscopy for femoroacetabular osteoplasty and unilateral labral treatment (repair or reconstruction), were prospectively enrolled. Patients were assessed pre- and postoperatively using the Hip-RSI, TSK-17, Hip Outcome Score (HOS), and HOS-sport subscale, with a minimum follow-up of 12 months. Results At 12-month follow-up, significant improvements were observed in both functional outcomes (HOS: 44.5 to 51; HOS-sport: 26.5 to 29) and psychological measures (Hip-RSI: 120 to 360; TSK-17: 33 to 20). Three patients were excluded due to conversion to total hip arthroplasty within one year. Psychological variables emerged as the strongest predictors of RTS: Hip-RSI demonstrated a positive association, whereas TSK-17 showed a negative association. In contrast, functional scores exhibited lower predictive value. Discussion These findings underscore the pivotal role of psychological factors in postoperative recovery and return to sport. Greater psychological readiness and reduced kinesiophobia were associated with improved outcomes, whereas functional measures alone appeared less reflective of the actual capacity to resume sport. Conclusions Preoperative psychological status represents a significant predictor of return to sport. The routine incorporation of psychological assessment into clinical practice may facilitate the identification of patients at risk of delayed recovery, allowing for targeted interventions and optimization of RTS to pre-symptomatic levels.