No abstract

Conservative management for individuals with pre-arthritic hip pain is commonly prescribed prior to consideration of surgical management. The purpose of this study is to determine if patients with pre-arthritic hip pain will improve their functional movement control and clinical outcome measures following the implementation of physical therapy and a home-exercise programme. Information was retrospectively collected on consecutive patients and included: demographics, diagnosis, initial and follow-up evaluation of the single leg squat test (SLST) and step-down test (SDT), and patient-reported outcome measures. An independent t-test and one-way analysis of covariance were performed for continuous patient-reported outcome measures and a Fisher’s exact test was performed for patient satisfaction. Forty-six patients (31 female and 15 male) diagnosed with pre-arthritic hip pain were included. A total of 30 patients improved their functional movement control during performance of the SLST, whereas 31 patients improved performance of the SDT. There was a statistically significant difference between patients that improved and did not improve (P ≤ 0.017). Patients with pre-arthritic hip pain who improved their functional movement control following a prescribed rehabilitation intervention are likely to report less pain and greater functional ability in their daily and sports-related activities. This study supports conservative management to acutely improve outcomes for patients with pre-arthritic hip pain.

Advanced hip jointepreserving arthroscopic techniques have been shown to improve patient-reported functional outcomes with low rates of postoperative complications. Prior work has shown that formation of adhesive scar is a potential source of persistent pain and cause for revision surgery. As resources for postoperative in-studio physical therapy become scarce, a home-based strategy to avoid scar formation without adding formal therapy cost may be beneficial. The purpose of this technical note is to introduce a patient-centered educational video technique for home-caregiver delivery of manual hip pendulum exercises in the postoperative setting. This video technique offers access to our method for pendulum exercise as part of early recovery after advanced hip arthroscopy.

The purpose of the current study was to present pre-operative comparisons for recreational athletes attempting a return to running following hip arthroscopy, and the return to running progression protocol used to guide them. A prospective, non-randomized cohort study was conducted to evaluate recreational athletes that returned to running following hip arthroscopy. Return to running was the primary outcome measure and defined as the ability to run at least one mile three times weekly while maintaining patient-reported relief of pre-operative symptoms. Patients included were correlated with the following pre-operative patient-reported outcome measures: hip outcome score (HOS), 12-item international outcome tool (iHOT-12), visual analog scale for pain (VAS) and the Short-Form Health Survey (SF-12). Of the 99 included patients, 94 (95%) returned to running successfully with an average return of 4.8 months. There was no statistical difference in pre-operative comparisons between patients that returned to running and did not return to running (P ≥ 0.154). Evaluation of pre-operative clinical outcomes demonstrated no statistical difference between individuals that returned and did not return to running (P ≥ 0.177), but a large difference between the two groups was identified for HOS-ADL (64.8 versus 53.7, returned versus did not return), iHOT-12 (33.8 versus 25.4) and VAS (58.6 versus 69.3). Patients who returned to running demonstrated similar intraoperative procedures as those that did not return to running (P ≥ 0.214). The current study successfully establishes a management plan and progression protocol for patients identifying a return to recreational running following hip arthroscopy. Level of evidence: 3.

No abstract

To describe the ‘mini-Max’ approach to labrum repair using non-absorbable 2.4-mm knotless suture anchors and report objective clinical outcomes with a large single-surgeon cohort. Level 3 retrospective case series. A retrospective review was conducted to report the use and allocation of non-absorbable 2.4-mm knotless suture anchors during ‘mini-Max’ labral repair from 2015 to 2018. Descriptive analysis of the labral damage severity, size and number of anchors used to arthroscopically repair the acetabular labrum was performed. Paired-samples t-tests were performed to evaluate whether preoperative and 1-year follow-up patient-reported outcomes (PROs) were statistically significant. An analysis of variance was performed comparing PROs with categorized number of labral anchors. A total of 390 patients were queried in this study, with 330 (85%) diagnosed intraoperatively with acetabular labral tears. A total of 245 patients (137 females and 108 males) with a mean age of 30.1 ± 11.6 years (mean ± SD) at the time of surgery underwent ‘mini-Max’ labral refixation. Of the 245 labral tears, 88 (35.9%) were graded as mild, 113 (46.1%) as moderate and 44 (18.0%) as severe. Labral repairs required an average of 2.1 ± 0.67 anchors across all patients included. Forty-one repairs (16.7%) required one anchor, 139 (56.7%) required two anchors, 63 (25.7%) required three anchors and 2 (0.8%) required four anchors. Significant improvements were reported for all PROs (P ≤ .001) at a minimum of 1-year follow-up. Arthroscopic ‘mini-Max’ labral repair using non-absorbable knotless suture anchors is a safe and effective technique for improving the lives of patients suffering from symptomatic acetabular labrum tears.