Lesions to articular cartilage can be difficult to treat and directly impact surgical outcome in hip arthroscopy. This article describes a direct cartilage suture repair technique for a young, active individual with full-thickness acetabular cartilage delamination. Lesions of this type are commonly seen with femoroacetabular impingement. A 17-year-old boy presented with bilateral hip pain greater in the right than left. Arthroscopic intervention for the right hip included direct cartilage repair for the cartilage lesion, osteoplasty for femoroacetabular impingement, repair for an anterior labral tear, capsular plication for iliofemoral ligament laxity, and psoas lengthening. Twelve weeks postoperatively, a standard capsular plication, osteoplasty, and chondroplasty were performed on the left hip. At follow-up, the patient reported feeling 95% normal. He noted that the right and left hips were essentially the same. Symptoms consisted of stiffness after prolonged sitting and mild pain following sports. The patient reported being pain free 90% of the time, with pain 2/10 at worst. He scored a 96 on the modified Harris Hip Score, 93 on the Hip Outcome Score Activities of Daily Living subscale, and 81 on the Hip Outcome Score Sports subscale. Overall, the patient was satisfied with the outcome. The direct cartilage repair, in addition to osteoplasty, anterior superior labral repair, iliofemoral capsular plication, and psoas lengthening, produced an excellent outcome in this young, active patient.

Therapeutic case series with no comparison group, Level IV.

BackgroundThe Foot and Ankle Ability Measure (FAAM) is a Patient Reported Outcome (PRO) commonly used to determine the effectiveness of therapeutic interventions for patients with foot and ankle pathologies and associated impairments of body function and structure, activity limitations, and participation restrictions. The aim of this study was to cross-culturally adapt the FAAM into Spanish.MethodsCross-cultural adaptation was performed according to the international guidelines of the International Society for Pharmacoeconomics and Outcomes Research. Cronbach’s alpha, test re-test reliability, and item-total and inter-item correlations were analyzed. Confirmatory factor analysis (CFA) was carried out to test construct validity. Pearson correlations were calculated to assess the convergent validity between FAAM and EuroQol-5.ResultsSpanish data set comprised 194 patients, with a mean age of 38.45 (16.04) and 130 (67.1%) were female, seeing a podiatrist with a wide variety of foot and ankle related disorders. CFA was carried out to test structure matrix (which has three factors). The test–retest reliability was high with global ICC of 0.95 (95% CI: 0.93 to 0.98). A 15 items version of the FAAM-Sp Activities of Daily Living (ADL) obtained the best fit: relative chi-square (x 2/df) of 2.46, GFI 0.90 CFI 0.95, NFI 0.93, and RMSEA 0.08 (90% CI 0.04 to 0.09). For exploratory factor analysis for the FAAM-Sp Sport, a one factor solution was obtained, which explained 76.70% of total variance. CFA corroborated this model with an excellent goodness of fit:: relative chi-square (x 2/df) of 0.80, GFI 0.99 CFI 1.00, NFI 0.99, and RMSEA 0.00 (90% CI 0.00 to 0.75).ConclusionsThis study validated a new 15-item FAAM-Sp ADL and FAAM-Sp Sport subscales, which can be used as a self-reported outcome measure in clinical practice and research for patients resident in Spain whose main language is Spanish.

The 2019 International Society of Hip Preservation (ISHA) physiotherapy agreement on femoroacetabular impingement syndrome (FAIS) was intended to build an international physiotherapy consensus on the assessment, non-surgical physiotherapy treatment, pre-/post-operative management, and return to sport decisions for those patients with FAIS. The panel consisted of 11 physiotherapists and 8 orthopaedic surgeons. There is limited evidence regarding the use of physiotherapy in the overall management of those with FAIS. Therefore, a group of ISHA member physiotherapists, who treat large numbers of FAIS patients and have extensive experience in this area, constructed a consensus statement to guide physiotherapy-related decisions in the overall management of those with FAIS. The consensus was conducted using a modified Delphi technique. Six major topics were the focus of the consensus statement: (i) hip assessment, (ii) non-surgical physiotherapy management, (iii) pre-habilitation prior to hip arthroscopy, (iv) post-operative physiotherapy rehabilitation, (v) stages of post-operative rehabilitation and (vi) return to sports criteria/guidelines after surgery.

TAA does not cause a change in proprioceptive abilities in arthritis patients when compared to the contralateral, unaffected side in a small sample of unilateral patients. Surgeons and rehabilitation professionals may use this information when designing rehabilitation plans following the insertion of a TAA.