Performance and return to sport outcomes following hip arthroscopy in National Hockey League players.

Abstract

Purpose: Intra-articular hip disorders, such as femoroacetabular impingement syndrome (FAIS), labral tears and chondral damage are common in ice hockey players, particularly in the National Hockey League (NHL). However, evidence on return-to-sport (RTS) rates and performance outcomes post-hip arthroscopy remains limited. This study evaluates RTS rates, career longevity, and performance metrics, including games played, points per game (PPG), save percentage, and performance scores (PS), following hip arthroscopy.

Methods: NHL players who underwent hip arthroscopy for intra-articular pathology between 2000 and 2024 were identified using public records. RTS rates, career duration, and performance metrics were analysed pre- and post-surgery. Paired t-tests and analyses of variance (ANOVA) were performed across positions (forwards, defensemen and goaltenders).

Results: A total of 92 NHL players (103 hips) met inclusion criteria. The overall RTS rate was 79.3%, increasing to 84.9% when excluding players still recovering. RTS was significantly higher in players <30 years (90.0% vs. 64.3%, p = 0.003). The average number of post-operative seasons played was 2.7, with no positional differences. Forwards showed significant declines in PPG (pre: 0.63 ± 0.38; post: 0.51 ± 0.37; p = 0.013) and PS (pre: 0.60 ± 0.74; post: 0.37 ± 0.69; ∆PS = -0.23; p = 0.026). Defensemen showed no significant change in PPG (p = 0.648) or PS (p = 0.509). Goaltenders had a decline in save percentage (pre: 0.91 ± 0.01; post: 0.89 ± 0.03; p = 0.038), while wins per season were unchanged (p = 0.205). RTS did not significantly differ by position.

Conclusion: NHL players undergoing hip arthroscopy have high RTS rates and often resume multi-season careers. However, forwards experience greater declines in performance, while defensemen and goaltenders are less affected. These results underscore position-specific recovery trends and may inform rehabilitation strategies in elite hockey athletes.

Level of evidence: Level V.