Hip chondropathy at arthroscopy: prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes

Kemp, Joanne L; Makdissi, Michael; Schache, Anthony G.; Pritchard, Michael; Pollard, T. C. B.; Crossley, Kay M

doi:10.1136/bjsports-2013-093312

Cited by 102 publications

(122 citation statements)

References 47 publications

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“…18,24 Moreover, patients with chondrolabral pathology have reduced patient-reported outcomes (PROs) for up to 3 years post hip arthroscopy. 23 Impairments of physical function in this postoperative patient group may also be present postoperatively but have never been evaluated. In addition, our previous studies have shown that age and chondropathy severity affect PRO scores, 22,23 and these factors should be considered when examining outcomes and impairments in patients with chondrolabral pathology.…”

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confidence: 99%

“…23 Impairments of physical function in this postoperative patient group may also be present postoperatively but have never been evaluated. In addition, our previous studies have shown that age and chondropathy severity affect PRO scores, 22,23 and these factors should be considered when examining outcomes and impairments in patients with chondrolabral pathology. As impairments in functional tasks, such as hopping distance and endurance in rising to standing on 1 leg, may ex-…”

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confidence: 99%

“…25 The covariates used in the analyses of covariance were age, sex, weight, and severity of chondropathy, based on the known age-related variability in functional task performance, the between-group differences in sex and weight in this study, and our previously published work outlining the impact of age and severity of chondropathy on PROs. 23 Between-group differences for hip muscle strength were not evaluated in the current study, as we have previously published these data, 24 with between-group mean differences ranging from 0.09 Nm·kg -1 (95% confidence interval [CI]: 0.00, 0.17; P = .044) for external rotation strength to 0.31 Nm·kg -1 (95% CI: 0.19, 0.42; P<.001) for flexion strength.…”

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confidence: 99%

“…In addition, covariates of age, sex, weight, and chondropathy severity were included in each model, as our previous studies have shown that these characteristics impact PRO scores. 22,23 The covariates could be eliminated in each model. Therefore, up to 6 independent variables (2 strength measures and 4 covariates) were used in total in each regression analysis.…”

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confidence: 99%

“…The recruitment procedure has been described in detail previously. 23 Sixty controls were recruited from the community. All participants completed written informed consent and fulfilled inclusion criteria.…”

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Patients With Chondrolabral Pathology Have Bilateral Functional Impairments 12 to 24 Months After Unilateral Hip Arthroscopy: A Cross-sectional Study

Kemp¹,

Risberg²,

Schache³

et al. 2016

J Orthop Sports Phys Ther

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T t STUDY DESIGN:Cross-sectional study. T t BACKGROUND:Functional task performance in patients with chondrolabral pathology following hip arthroscopy is unknown. T t OBJECTIVES:To investigate in people with chondrolabral pathology following hip arthroscopy (1) the bilateral differences in functional task performance compared to controls, (2) the association of hip muscle strength with functional task performance, and (3) the association of functional task performance scores with good outcome, as measured by International Hip Outcome Tool score. T t METHODS:Seventy-one patients who had unilateral hip arthroscopy for hip pain and 60 controls were recruited. Patient-reported outcomes included the 4 subscales of the International Hip Outcome Tool. Hip muscle strength measures included abduction, adduction, extension, flexion, external rotation, and internal rotation. Functional tasks assessed included the single hop test, the side bridge test, and the single-leg rise test. For aim 1, analyses of covariance tests were used. For aim 2, stepwise multiple linear regression analyses were used. For aim 3, receiver operating characteristic curve analyses were used. T t RESULTS:Compared to controls, the chondrolabral pathology group had significantly worse performance on both legs for each of the functional tasks (P<.001). Greater hip abduction strength was moderately associated with better performance on functional tasks in the chondrolabral pathology group (adjusted R 2 range, 0.197-0.407; P<.001). Cutoff values associated with good outcome were 0.37 (hop distance/height) for the single hop, 16 repetitions for the single-leg rise, and 34 seconds for the side bridge test. T t CONCLUSION:Patients with hip chondrolabral pathology had reduced functional task performance bilaterally 12 to 24 months after unilateral hip arthroscopy when compared to controls. T t LEVEL OF EVIDENCE: Therapy/symptom prevalence, level 3b.

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Patients With Chondrolabral Pathology Have Bilateral Functional Impairments 12 to 24 Months After Unilateral Hip Arthroscopy: A Cross-sectional Study

Kemp¹,

Risberg²,

Schache³

et al. 2016

J Orthop Sports Phys Ther

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Hip muscle atrophy in patients with acetabular labral joint pathology

et al. 2019

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Intra‐articular hip joint pathology is a source of hip and groin pain in active individuals and is thought to be a precursor to hip osteoarthritis. Limited evidence exists to guide appropriate physiotherapy management for these patients. Identification of which hip muscles are affected may help clinicians to develop effective exercise programs. A cross‐sectional observational study in a hospital setting was conducted to investigate the size of individual hip abductor, hip extensor, and hip external rotator muscles in patients with acetabular labral joint pathology compared with age and sex matched healthy subjects. Twelve participants (eight females, four males), aged 20–53 years, with a medical diagnosis of unilateral acetabular labral tear and 12 healthy participants were recruited. Magnetic resonance imaging was used to assess cross‐sectional areas of the gluteus minimus, gluteus medius, upper gluteus maximus, lower gluteus maximus, piriformis, and quadratus femoris muscles bilaterally. Gluteus medius muscle cross‐sectional area was significantly different between groups (P < 0.01, effect size = 0.92) with muscle size found to be smaller in the pathology group. No differences were found for the other hip muscles (P > 0.05). These findings suggest that hip muscles are not all affected equally by the presence of intra‐articular hip joint pathology. Atrophy of specific hip muscles, which are important in hip joint and pelvic stability, may alter hip joint function during gait and functional tasks. Clinicians treating patients with intra‐articular hip joint pathology may need to prescribe exercises targeting the specific muscles with demonstrated dysfunction. Clin. Anat. 33:538–544, 2020. © 2019 Wiley Periodicals, Inc.

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Strength and range of movement deficits are associated with symptom severity in people scheduled for hip arthroscopy

Freke

Kemp

Crossley

et al. 2019

European Journal of Pain

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Background Identifying the physical impairments associated with worse symptoms and greater functional limitations in people with hip pain could enable targeted rehabilitation programmes designed to improve quality of life. The objective of this study was to compare physical characteristics between subgroups of symptoms and functional limitation severity in individuals with hip pain scheduled for arthroscopic surgery. Methods Hip range of motion (ROM) and muscle strength were measured in 114 individuals (48 women; aged 32 ± 8 years) with hip pain scheduled for hip arthroscopy. Pain and disability were measured with the International Hip Outcome Tool (iHOT33) subscale of Symptoms and Functional Limitation, and a cluster analysis was used to identify mild, moderate and severe subgroups. Between‐group differences were then evaluated using multivariate analysis of covariance, including sex as a covariate, followed by post hoc testing. Significance was set at 0.05. Results Lesser hip muscle strength in all directions was reported in the severe symptoms and functional limitation group compared to the mild group. Hip flexion ROM differed when comparing the moderate to both the mild and severe subgroups. Hip internal rotation did not differ between subgroups of severity. Conclusions Individuals with hip pain and severe scores in the iHOT33 subscale of symptoms and functional limitations present with significantly lesser hip muscle strength and hip flexion ROM than individuals with moderate or mild scores. Targeted programmes to improve hip strength and flexion ROM in more severe patients may help reduce symptoms and improve function. Significance Individuals with severe hip pain and functional limitation possess significantly lesser muscle strength and flexion ROM than individuals with moderate or mild scores.

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Hip chondropathy at arthroscopy: prevalence and relationship to labral pathology, femoroacetabular impingement and patient-reported outcomes

Cited by 102 publications

References 47 publications

Patients With Chondrolabral Pathology Have Bilateral Functional Impairments 12 to 24 Months After Unilateral Hip Arthroscopy: A Cross-sectional Study

Patients With Chondrolabral Pathology Have Bilateral Functional Impairments 12 to 24 Months After Unilateral Hip Arthroscopy: A Cross-sectional Study

Hip muscle atrophy in patients with acetabular labral joint pathology

Strength and range of movement deficits are associated with symptom severity in people scheduled for hip arthroscopy

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