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Background: Previous studies have identified demographic, radiographic, and intraoperative predictors of outcomes after hip arthroscopy for femoroacetabular impingement syndrome, yet few studies have identified whether preoperative gait metrics can predict outcomes.Hypothesis: Increased preoperative step count, walking speed, step length, and gait symmetry will be associated with better outcomes after surgery.Study Design: Retrospective cohort study.Level of Evidence: Level 4.Methods: Patients who underwent hip arthroscopy between 2019 and 2022 and downloaded the smartphone app rHip, allowing for retroactive access of gait metric data, were identified. Preoperative gait metrics, age, sex, body mass index (BMI), and exercise participation were analyzed via multivariate stepwise linear regression for a relationship with 1-year postoperative patient-reported outcomes (PROs), including Hip Outcome Scale-Activities of Daily Living (HOS-ADL); HOS-Sports Subscale (HOS-SS), and 12-item international Hip Outcome Tool (iHOT-12). Thresholds for preoperative gait metrics were analyzed via receiver operator characteristic curve. A subgroup analysis was performed to compare those who did and did not reach this threshold.Results: A total of 43 patients (86% female; age, 33.1 ± 13.7 years; BMI, 23.9 ± 4.4 kg/m2) met inclusion criteria. Multivariate regression found that preoperative walking speed was significantly associated with postoperative HOS-ADL, HOS-SS, and iHOT-12 (P≤ .01). A preoperative walking speed threshold of 1.065 m/s was predictive of outcome achievement. Those who failed to achieve this threshold were significantly older, of greater BMI, and less active (P≤ .04). They also showed significantly worse 1-year postoperative scores (P≤ .02) and lower PASS achievement for HOS-ADL, HOS-SS, and iHOT-12 (P≤ .04).Conclusion: Preoperative walking speed is significantly associated with 1-year outcomes after hip arthroscopy. Patients who averaged <1.065 m/s show significantly worse outcomes after surgery.Clinical Relevance: Assessment of preoperative walking speed may allow physicians to better counsel patients regarding expected outcomes after hip arthroscopy.

Hip pathology is a common source of pain and dysfunction in athletes. Taking a layered approach to the history and physical examination of the athlete's hip is imperative to deciphering the vast differential diagnoses for an athlete's hip pain. Systematic evaluation of the (1) osteochondral, (2) capsulolabral, (3) musculotendinous, (4) neurovascular, and (5) kinematic chain layers of the hip allow for the comprehensive consideration of hip pain etiologies, including femoroacetabular impingement syndrome, labral tears, osteoarthritis, Coxa Saltans, hamstring and gluteal tendinopathy, and sacroiliac joint dysfunction, among numerous other conditions. A thorough history, including the location, acuity, quality, radiation, and sport-specific limitations of the hip pain, followed by a methodologic physical examination, with ordered inspection, gait, palpation, range of motion, strength testing, and provocative maneuvers, allows clinicians to arrive at an early and accurate diagnosis of hip pain. Only after a thorough history and physical examination can more specific diagnostic and therapeutic modalities be applied. [ABSTRACT FROM AUTHOR]