Hip Function 6 to 10 Months After Arthroscopic Surgery: A Cross-sectional Comparison of Subjective and Objective Hip Function, Including Performance-Based Measures, in Patients Versus Controls

Wörner, Tobias; Nilsson, Johanna; Thorborg, Kristian; Granlund, Viktor; Stålman, Anders; Eek, Frida

doi:10.1177/2325967119844821

Cited by 9 publications

(8 citation statements)

References 44 publications

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“…However, just half of all athletes undergoing hip arthroscopy return to their pre-injury sport and one in five returns to previous performance levels [ 6 , 22 ]. Recent research suggests that physical impairments alone cannot explain these low RTS rates, or the marked impairments in self-reported function observed in these patients [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Psychological readiness is related to return to sport following hip arthroscopy and can be assessed by the Hip-Return to Sport after Injury scale (Hip-RSI)

Wörner¹,

Thorborg²,

Webster³

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Psychological readiness may play an important role in the return to sport (RTS) process following hip arthroscopy (HA), but there are limited tools for the measurement of this construct. The aim of this study was to modify the Swedish version of the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale for use in HA patients and evaluate its psychometric properties. Methods Content validity of a modified version of the Swedish ACL-RSI (Hip-RSI) was evaluated through 127 HA patient responses and relevance ratings by an expert panel (35 patients, 9 surgeons, 11 physiotherapists). Items with low relevance were omitted. Construct validity was assessed by the association of Hip-RSI scores to hip-related sporting function (HAGOS sport) and quality of life (iHOT12). Hip-RSI scores were compared between patients who had not returned, or returned to sport participation, previous sport, and sport performance. Results Item reduction resulted in a 6-item Hip-RSI scale with adequate content validity for the target population. Construct validity of the full and the item-reduced scale was demonstrated by correlation to HAGOS sport and iHOT12 (r 0.631-0.752). A gradient increase in Hip-RSI scores was found for patients returning to sport participation, previous sport, and sport performance. Conclusion The short version of the Swedish Hip-RSI is a valid tool for the assessment of psychological readiness to RTS and can be recommended to be used in HA patients. Higher psychological readiness to RTS, assessed by the Hip-RSI, is found with increasing levels of return to sports following HA. Level of evidence III.

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Section: Introductionmentioning

confidence: 99%

Psychological readiness is related to return to sport following hip arthroscopy and can be assessed by the Hip-Return to Sport after Injury scale (Hip-RSI)

Wörner¹,

Thorborg²,

Webster³

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…The conclusions of this chapter are very similar to another recently published study [240] that assessed hip strength, ROM and PROMs in an FAIS population at an average of eight months post arthroscopy.…”

Section: Chapter Reviewsupporting

confidence: 85%

“…Worner et al [240] also found flexion strength, internal rotation ROM and PROMs were significantly less than matched controls. However, the lack of pre-surgical assessment made it impossible to determine if strength or ROM had changed following the intervention of arthroscopy and subsequent rehabilitation.…”

Section: Chapter Reviewmentioning

confidence: 89%

Clinical predictors of outcome following hip arthroscopy

Freke¹

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Intra-articular hip pathology, including femoro-acetabular impingement syndrome (FAIS), is a cause of hip and groin pain in otherwise healthy young adults. While arthroscopic surgery in the hip joint has historically lagged behind its counterparts in the shoulder and knee, there has recently been a rapid evolution of the management of hip injuries in the young, active population utilizing hip arthroscopic techniques which has improved understanding of mechanical hip pathology. The aims of this thesis were to; investigate the clinical presentation of individuals scheduled to undergo hip arthroscopy; assess and report pre-operative deficits in hip strength, range of movement (ROM) and dynamic balance; determine the changes that occur post surgery, and; identify potentially modifiable predictors of outcome post arthroscopy.A review of literature revealed that there is limited evidence that those with FAI syndrome have reduced hip abduction and flexion ROM compared to healthy matched controls. There were no differences in hip adduction or extension ROM, and conflicting results for external rotation and internal rotation ROM. However, people with symptomatic FAIS demonstrated deficits in hip muscle strength and reduced dynamic balance on one leg when compared to controls. For hip joint ROM, there were no significant within-group differences between pre and post intervention time points while hip muscle strength improved significantly from pre to post-hip arthroscopy in a single case series.In people undergoing hip arthroscopy, severe femoral head chondropathy, large labral tears, along with a high prevalence of labral pathology and acetabular chondropathy, were relatively common findings. Severe femoral head chondropathy and large labral tears were most associated with patient related outcomes (PROs), however, at best only explained 22% of the variability. Individuals with hip pain and severe scores in the International Hip Outcome Tool (iHOT33) subscale of symptoms and functional limitations presented with significantly lesser hip muscle strength and hip flexion ROM when compared to individuals with moderate or mild scores. Individuals scheduled for arthroscopic hip surgery were also significantly weaker, had less hip mobility and reduced dynamic balance compared to healthy matched controls. In the hip pain population, dynamic balance performance was associated with various hip strength and ROM measurements in a direction specific manner. The clinical significance of these findings may assist therapists in providing targeted rehabilitation programs for people with FAIS and chondrolabral hip pain to improve hip strength and ROM, help reduce symptoms and to improve function. 3 By three months post arthroscopy to address bony morphology and/or chondrolabral pathology, all directions of hip strength (with the exception of adduction squeeze in crook lying and flexion) and hip flexion ROM were significantly improved. While by six months post arthroscopy, strength in all directions, and flexion and rotation ROM were signifi...

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“…Studies that present measurements of muscle strength and range of motion often compare postsurgery patients with clinical controls [ 30 , 31 , 32 ]. Most of the available literature provides an account of patients’ states before and after surgical intervention [ 31 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…They found that hip flexion strength and passive range of motion of flexion remained reduced. There was a significant difference in the flexion ROM between the operated limb and nonoperated limbs [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Functional Condition of Patients after Unilateral Hip Arthroscopy in the Process of FAI—Femoroacetabular Impingement: A Case–Control Study and Preliminary Report

Nieszporska

Truszczyńska-Baszak

2021

JCM

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Introduction: Femoroacetabular impingement is a commonly recognized condition among people with hip pain. Aim: The aim of this study was to assess how arthroscopy and physiotherapy treatment influenced the quality of life and functional condition of patients after arthroscopic femoroacetabular impingement (FAI) surgery. Materials and methods: We examined 19 people for the study and included 12 (6 men and 6 women). Their mean age was 40.1 ± 9.7 years. Manual and digital goniometers were used for the range of motion (ROM) measurements, and a dynamometer for muscle strength was used. Results from the operated limb were compared to the nonoperated healthy limb. We examined the patient’s health and well-being using the Harris Hip Score (HHS) and Short-Form Health Survey (SF-36) scales. The mean follow-up period was 21.2 months. Results: The postsurgery mean range of motion for all movements was lower in the operated limb. Statistically significant differences between limbs in ROM were observed for flexion, abduction, extension, and external rotation. Muscle strength was comparable between hip joints, except extension and adduction, which were statistically significantly weaker. The mean strength of the hip flexors and internal rotators was higher in the operated limb. After surgery, 67% of patients returned to exercise at the same or higher level. The mean HHS results were good, with values of 88.00 ± 11.48. The SF-36 scores were >50. Conclusion: After surgery and physiotherapy of FAI, ROM remained lower in the operated limb. Flexion and rotations remained to cause pain. The strength of flexors and internal rotators improved, and there was a high rate of return to sport.

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Hip Function 6 to 10 Months After Arthroscopic Surgery: A Cross-sectional Comparison of Subjective and Objective Hip Function, Including Performance-Based Measures, in Patients Versus Controls

Cited by 9 publications

References 44 publications

Psychological readiness is related to return to sport following hip arthroscopy and can be assessed by the Hip-Return to Sport after Injury scale (Hip-RSI)

Psychological readiness is related to return to sport following hip arthroscopy and can be assessed by the Hip-Return to Sport after Injury scale (Hip-RSI)

Clinical predictors of outcome following hip arthroscopy

Functional Condition of Patients after Unilateral Hip Arthroscopy in the Process of FAI—Femoroacetabular Impingement: A Case–Control Study and Preliminary Report

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