Preoperative Predictors of Achieving Clinically Significant Athletic Functional Status After Hip Arthroscopy for Femoroacetabular Impingement at Minimum 2-Year Follow-Up

Stone, Austin V.; Beck, Edward C.; Malloy, Philip; Chahla, Jorge; Nwachukwu, Benedict U.; Neal, William H.; Nho, Shane J.

doi:10.1016/j.arthro.2019.05.022

Cited by 44 publications

(36 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…49 Our methodology here is in line with adopted and accepted FAI, KINESIOPHOBIA, AND PAIN CATASTROPHIZING e99 methods previously reported and supported in the literature. 45,[49][50][51][52] Statistical Analysis All data were screened to determine whether parametric statistical assumptions were met before analysis. In cases of parametric analysis violation, the nonparametric analogue tests were applied.…”

Section: Functional Outcome Evaluationmentioning

confidence: 99%

What is the Role of Kinesiophobia and Pain Catastrophizing in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome?

Clapp

Nwachukwu

Beck

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

Self Cite

View full text Add to dashboard Cite

Purpose: To (1) investigate trends in kinesiophobia and pain catastrophizing after hip arthroscopy for femoroacetabular impingement syndrome (FAIS), and (2) determine whether kinesiophobia and pain catastrophizing scores are associated with achieving minimal clinically important difference (MCID) for any of the hip-specific patient-reported outcome questionnaires. Methods: Patients undergoing primary hip arthroscopy for treatment of FAIS between December 2016 and March 2017 were prospectively enrolled. Patients received the Tampa Scale of Kinesiophoibia-11 (TSK-11) and Pain Catastrophizing Scale (PCS) questionnaires preoperatively, 6 months, and 1 year postoperatively. They also received the hip-specific patient-reported outcome questionnaires (Hip Outcome Score Activities of Daily Living and Sport-Specific subscales, modified Harris Hip Score, and International Hip Outcome Tool-12), as well as visual analog scale for satisfaction and pain preoperatively and 1-year postoperatively. The threshold for achieving MCID was determined for each hip outcome tool, and patients achieving MCID were compared with those who did not. Results: A total of 85 (80.2%) patients (mean age: 33.7 AE 12.4 years; female: 75.3%) were included in the final analysis. At 1-year follow-up, there was a significant reduction in TSK-11 scores (26.22 AE 5.99 to 18.70 AE 6.49; P < .001) and PCS scores (17.81 AE 10.13 to 4.77 AE 7.57; P < .001) when compared with preoperative scores. 1-year PCS scores were significantly lower in patients achieving MCID compared with patients failing to achieve MCID (3.2 AE 4.4 vs 10.8 AE 15.2; P ¼ .006). There were no significant differences in TSK-11 scores between those achieving and not achieving MCID. Conclusions: Patient kinesiophobia and pain catastrophizing both show significant improvements 1 year after undergoing hip arthroscopy for FAIS. However, pain catastrophizing scores at 1 year are significantly greater in patients not achieving MCID, whereas no association was identified between kinesiophobia and likelihood for MCID achievement. This suggests PCS may be a more useful tool than TSK-11 during postoperative rehabilitation for identifying patients at risk for not achieving MCID.

show abstract

Section: Functional Outcome Evaluationmentioning

confidence: 99%

What is the Role of Kinesiophobia and Pain Catastrophizing in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome?

Clapp

Nwachukwu

Beck

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

Self Cite

View full text Add to dashboard Cite

show abstract

“…5,9,31,38 Although hip arthroscopy has been shown to be largely successful, demonstrating improvements in patient-reported outcomes at short- to mid-term follow-up, persistent or recurrent symptoms may develop in a subset of patients. 10,12,29,40 Revision arthroscopy rates have been shown to range from as low as 2.6% up to 15.4% depending on surgeon volume. 20,32,43 One potential factor associated with these symptoms may be capsular deficiency and resultant “microinstability” or, more rarely, gross instability.…”

mentioning

confidence: 99%

A Biomechanical Comparison of 2 Hip Capsular Reconstruction Techniques: Iliotibial Band Autograft Versus Achilles Tendon Allograft

et al. 2020

View full text Add to dashboard Cite

Background: Several techniques for hip capsular reconstruction have been described to address gross instability or microinstability due to capsular deficiency. However, objective biomechanical data to support their use are lacking. Purpose: To compare the kinematic effect of 2 capsular reconstruction techniques (iliotibial band [ITB] graft and Achilles tendon graft). Kinematic effect encompassed rotational range of motion (ROM) as well as joint translation in the coronal, sagittal, and axial planes. Study Design: Controlled laboratory study. Methods: 8 paired, fresh-frozen hemi-pelvises (16 hips) were tested on a custom-designed joint motion simulator in the intact state and after capsulectomy. Pairs were randomly allocated to either ITB or Achilles reconstruction and retested. Testing was performed at 0°, 45°, and 90° of flexion. Internal-external rotation (IR-ER) torques and abduction-adduction torques of 3 N·m were applied to the femur via a load cell at each position, and rotational ROM and joint translation in the coronal, sagittal, and axial planes were recorded. Results: At 45° and 90°, there was a significant effect of the condition of the hip on the total IR-ER ( P = .004, effect size [ES] = 0.305; and P < .001, ES = 0.497; respectively). At 45°, mean ± SD total rotation was significantly greater for the capsulectomy (59.7°± 15.9°) state compared with intact (53.3°± 13.2°; P = .007). At 90°, reconstruction significantly decreased total rotation to 49.0°± 18.9° compared with a mean total rotation of 52.8°± 18.7° after capsulectomy ( P = .02). No difference was seen in the total abduction-adduction of the hip between conditions. Comparisons of the 2 different reconstruction techniques showed no significant differences in total IR-ER or abduction-adduction ROM or joint translation in the coronal, sagittal, or axial planes. For translation, at both 0° and 45° there was a statistically significant effect of the condition on the medial-lateral translation ( P = .033; ES = 0.204). Reconstruction, independent of technique, was successful in significantly decreasing ( P = .030; P = .014) the mean medial-lateral translation at 0° and 45° of hip flexion from 5.2 ± 3.8 mm and 5.6 ± 4.0 mm to 2.8 ± 1.9 mm and 3.9 ± 3.2 mm, respectively. Conclusion: The integrity of the native hip capsule played a significant role in rotational stability, where capsulectomy significantly increased rotational ROM. Both ITB and Achilles reconstruction techniques restored normal rotational ROM of the hip at 90° of flexion as well as coronal plane stability at 0° and 45° of hip flexion. No differences were seen between ITB and Achilles reconstruction techniques. Clinical Relevance: Both capsular reconstruction techniques provide comparable joint kinematics, restoring rotation and translation to normal values with the exception of rotational ROM at 45°, which remained significantly greater than the intact state. The most significant results were the rotational stability at 90° of hip flexion and coronal plane stability at 0° and 45° of hip flexion, which were significantly improved compared with the capsulectomy state.

show abstract

“…[2][3][4][5][6][7][8] Items 1 through 6 are negative predictive factors that have been identified in the current manuscript by Stone et al1 1. Presence of femoral chondral damage 2.…”

mentioning

confidence: 66%

Editorial Commentary: Patient Profiling: Identifying Risk Factors That Help Predict Outcomes of Hip Arthroscopy Candidates

Aoki

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Hip pain in the young athletic population is often caused by femoroacetabular impingement morphology. If a patient fails conservative management, hip arthroscopy becomes a potential treatment option. Our ability to maximize patient outcomes after hip arthroscopy is directly related to preoperative patient selection, intraoperative technical ability, and attention to detail in the postoperative period. When considering surgery as a therapeutic option, we want to first identify that the pain is truly stemming from the hip. Once the hip is identified as the culprit, then we proceed with the responsibility of discussing pros and cons and risks and benefits to each patient to critically evaluate whether surgical treatment is a viable option. With the explosion of literature in the field of hip preservation, we have recognized certain modifiable and nonmodifiable risk factors that aid us in identifying patients who may have difficulty in achieving their functional athletic expectations after surgery.

show abstract

Preoperative Predictors of Achieving Clinically Significant Athletic Functional Status After Hip Arthroscopy for Femoroacetabular Impingement at Minimum 2-Year Follow-Up

Cited by 44 publications

References 42 publications

What is the Role of Kinesiophobia and Pain Catastrophizing in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome?

What is the Role of Kinesiophobia and Pain Catastrophizing in Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome?

A Biomechanical Comparison of 2 Hip Capsular Reconstruction Techniques: Iliotibial Band Autograft Versus Achilles Tendon Allograft

Editorial Commentary: Patient Profiling: Identifying Risk Factors That Help Predict Outcomes of Hip Arthroscopy Candidates

Contact Info

Product

Resources

About