Return to sport after acetabular and pelvic ring fractures in amateur athletes: A retrospective study

Background: Acetabular fractures are complex hip injuries with high social and economic costs, as they affect individuals of working age. These fractures often result in long-term complications, including chronic pain and sexual dysfunction, which impair quality of life and limit physical activity. With growing interest in fitness, understanding factors that impact return to sport post injury is critical. This study examines how fracture type and surgical approach influence functional recovery and return to sport after acetabular and pelvic fractures. Material and methods: This retrospective cohort study analyzed outcomes in patients with acetabular and pelvic ring fractures, focusing on their ability to return to sport. Patients treated between 2018 and 2022 at Policlinico Universitario A. Gemelli in Rome were included, specifically those with isolated fractures managed by open reduction internal fixation (ORIF) or closed reduction internal fixation (CRIF) techniques. Demographic and clinical data were collected, and fractures were categorized by Judet–Letournel (acetabular) or Young–Burgess (pelvic ring) classifications. Outcomes were assessed using four physical activity-related scores: Hip Sport Activity Scale (HSAS), Hip Outcome Score (HOS), Tegner Activity Scale (TAS), and Modifiable Activity Questionnaire (MAQ), alongside the 12-Item Short Form Health Survey (SF-12) for quality of life. Eligible participants, aged 18–65 years, had no prior surgeries or neurological/cardiopulmonary diseases, nor concurrent limb fractures or severe trauma. Data analysis used Student’s t-test and chi-squared tests for continuous and categorical variables, respectively, with analysis of variance (ANOVA) for subgroup comparisons. Results: The study included 35 patients, with 20 acetabular fractures (4:1 male/female ratio, average age 45.3 years) and 15 pelvic ring fractures (6.5:1 male/female ratio, average age 51.3 years). Follow-up averaged 1074 days for the acetabular group and 1446 days for the pelvic group. Clinical outcomes showed that both groups had similar Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12) scores, with no statistically significant differences (p > 0.05). Total MAQ scores were higher in the pelvic group, mainly owing to higher work-related activity scores, while sport-related scores were similar. Hip Outcome Scores (HOS) also indicated comparable function in daily activities and sports, with acetabular fractures scoring 72.2 and pelvic fractures scoring 74.8. HSAS and TAS measures showed no significant difference between groups. Subgroup analysis found no significant outcome differences on the basis of fracture location (anterior versus posterior acetabulum or pelvic ring patterns). Conclusions: The study found no statistically significant differences in return-to-sport outcomes between acetabular and pelvic ring fractures, highlighting the complexity of both injuries. Future research with larger samples and standardized functional scores is recommended for clearer insights into recovery outcomes. Level of evidence: III