Descriptive Epidemiology of Femoroacetabular Impingement

Clohisy, John C.; Baca, Geneva; Beaulé, Paul E.; Kim, Young Jo; Larson, Christopher M.; Millis, Michael B.; Podeszwa, David A.; Schoenecker, Perry L.; Sierra, Rafael J.; Sink, Ernest L.; Sucato, Daniel J.; Trousdale, Robert T.; Zaltz, Ira

doi:10.1177/0363546513488861

Cited by 207 publications

(83 citation statements)

References 39 publications

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“…1 Hip arthroscopy may include a combination of these procedures. 13,14 The postoperative rehabilitation program was defined as a structured rehabilitation program within the scope of a rehabilitation professional and included interventions such as manual therapy, therapeutic exercise, functional activity, sportspecific training, and modalities. Given the paucity of research identified, we included studies that reported at minimum weight-bearing restrictions, range-of-motion parameters, and return to premorbid activities.…”

Section: Evidence Acquisitionmentioning

confidence: 99%

Postoperative Rehabilitation After Hip Arthroscopy: A Search for the Evidence

Cheatham¹,

Enseki²,

Kolber³

2015

Journal of Sport Rehabilitation

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Context: Hip arthroscopy has become an increasingly popular option for active individuals with recalcitrant hip pain. Conditions that may be addressed through hip arthroscopy include labral pathology, femoral acetabular impingement, capsular hyperlaxity, ligamentum teres tears, and the presence of intra-articular bodies. Although the body of literature examining operative procedures has grown, there is a paucity of evidence specifically on the efficacy of postoperative rehabilitation programs. To date, there are no systematic reviews that have evaluated the available evidence on postoperative rehabilitation. Objective: To evaluate the available evidence on postoperative rehabilitation programs after arthroscopy of the hip joint. Evidence Acquisition: A search of the PubMed, CINAHL, SPORTDiscus, ProQuest, and Google Scholar databases was conducted in January 2014 according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews. Evidence Synthesis: Six studies met the inclusion criteria and were either case series or case reports (level 4 evidence) that described a 4-or 5-phase postoperative rehabilitation program. The available evidence supports a postoperative period of restricted weight bearing and mobility; however, the specific interventions in the postoperative phases are variable with no comparison trials. Conclusion: This review identified a paucity of evidence on postoperative rehabilitation after hip arthroscopy. Existing reports are descriptive in nature, so the superiority of a particular approach cannot be determined. One can surmise from existing studies that a 4-to 5-stage program with an initial period of weight-bearing and mobility precautions is efficacious in regard to function, patient satisfaction, and return to competitive-level athletics. Clinicians may consider such a program as a general guideline but should individualize treatment according to the surgical procedure and surgeon guidelines. Future research should focus on comparative trials to determine the effect of specific postoperative rehabilitation designs.

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Section: Evidence Acquisitionmentioning

confidence: 99%

Postoperative Rehabilitation After Hip Arthroscopy: A Search for the Evidence

Cheatham¹,

Enseki²,

Kolber³

2015

Journal of Sport Rehabilitation

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“…6, 10 Diagnoses associated with CHJP include femoroacetabular impingement (FAI), 17 structural instability, 52 acetabular labral tears 36 and chondral lesions. 42 Often individuals with CHJP have limitations in sitting and standing, thus restricting their ability to work or complete everyday tasks.…”

Section: Introductionmentioning

confidence: 99%

“…42 Often individuals with CHJP have limitations in sitting and standing, thus restricting their ability to work or complete everyday tasks. 6, 10 Without proper management, conditions associated with CHJP may progress to hip osteoarthritis (OA). 16, 20, 41 To improve treatment of CHJP and potentially prevent or delay the onset of hip OA, there is a need to better understand the factors proposed to be associated with CHJP, in particular hip muscle performance.…”

Section: Introductionmentioning

confidence: 99%

Persons With Chronic Hip Joint Pain Exhibit Reduced Hip Muscle Strength

Harris‐Hayes

Mueller²,

Sahrmann³

et al. 2014

Journal of Orthopaedic & Sports Physical Therapy

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STUDY DESIGN Controlled Laboratory Cross-Sectional Study OBJECTIVES To assess strength differences of the hip rotator and abductor muscle groups in young adults with chronic hip joint pain (CHJP) and asymptomatic controls. A secondary objective was to determine if strength in the uninvolved hip of those with unilateral CHJP differs from asymptomatic controls. BACKGROUND Little is known about the relationship between hip muscle strength and CHJP in young adults. METHODS 35 participants with CHJP and 35 matched controls (18 to 40 years of age) participated. Using hand-held dynamometry, strength of the hip external rotators (ERs) and internal rotators (IRs) was assessed with the hip flexed to 90° (ERs90°, IRs90°) and 0° (ERs0°, IRs0°). To assess ER and IR strength, the hip was placed at the end-range of external rotation and internal rotation, respectively. Strength of the hip abductors (ABDs) was assessed in sidelying, with the hip in 15° of abduction. Break tests were performed to determine maximum muscle force and the average torque was calculated using the corresponding moment arm. Independent samples t-tests were used to compare strength values between the 1) involved limb in participants with CHJP and corresponding limb in the matched controls and 2) the uninvolved limb in participants with unilateral CHJP and corresponding limb in the matched controls. RESULTS Compared to controls, participants with CHJP demonstrated weakness of 16–28%, (P<0.01) in all muscle groups tested in the involved hip. The uninvolved hip of 22 subjects with unilateral CHJP demonstrated weakness of 18% and 16% (P<0.05) in the ERs0° and ABDs, respectively when compared to the corresponding limb of the matched controls. CONCLUSION Our results demonstrate that persons with CHJP have weakness in the hip rotator and hip abductor muscles. Weakness also was found in the uninvolved hip of persons with CHJP.

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“…28 The reported average duration of symptoms for participants with intra-articular hip pathology prior to surgery is 1 to 3 years, with 12% of patients having symptoms for more than 5 years. 5 It is possible that the long-standing duration of symptoms in the participants included in this study resulted in lack of use and subsequent deconditioning of both legs with respect to functional task performance. Finally, unilateral painful stimuli have been shown to activate the brain's cerebellum bilaterally, supplementary motor area contralaterally, and premotor area ipsilaterally.…”

mentioning

confidence: 99%

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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Descriptive Epidemiology of Femoroacetabular Impingement

Cited by 207 publications

References 39 publications

Postoperative Rehabilitation After Hip Arthroscopy: A Search for the Evidence

Postoperative Rehabilitation After Hip Arthroscopy: A Search for the Evidence

Persons With Chronic Hip Joint Pain Exhibit Reduced Hip Muscle Strength

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

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