Despite patient-reported outcomes improve, patients with femoroacetabular impingement syndrome do not increase their objectively measured sport and physical activity level 1 year after hip arthroscopic surgery. Results from the HAFAI cohort

Abstract

Purpose Patients with femoroacetabular impingement syndrome (FAIS) are young and middle‐aged persons living physically active lives including sports activities. However, measurements of the physical activity level before and after hip arthroscopic surgery in patients with FAIS using both self‐reported and objective accelerometer‐based measures are lacking. Furthermore, comparing patients with a reference group of persons reporting no hip problems and conducting subgroup analyses investigating changes in physical activity level and self‐reported outcomes according to pre‐surgery activity level may further highlight the activity pattern for patients. Methods Sixty patients with FAIS eligible for hip arthroscopic surgery were consecutively included in a prospective cohort study (HAFAI cohort) together with 30 reference persons reporting no hip problems. Participants completed the Copenhagen Hip and Groin Outcome Score (HAGOS) together with questions regarding their sports activities. Furthermore, participants wore a three‐axial accelerometer for five consecutive days during waking hours. The accelerometer‐based data were analysed and presented as total activity and type, frequency and duration of activities. Results Patients experienced significant and clinically relevant changes in all HAGOS scores. 88% of patients participated in some kind of sports activity 1 year after surgery. Overall, objectively measured physical activity did not change from before to 1 year after surgery. However, subgroup analyses of the most sedentary patients preoperatively revealed significant changes towards a more active pattern. Compared to reference persons, patients performed less bicycling and running. Conclusion Despite clinically relevant changes in self‐reported outcomes, patients did not increase their overall physical activity level 1 year after surgery. Physical activity levels were lower in patients than in the reference group and patients continued bicycling and running less compared with the reference group. Level of evidence II.

Physical Activity Following Hip Arthroscopy in Young and Middle-Aged Adults: A Systematic Review

“…Similarly, although only seven of the included studies sought to quantify the amount of activity undertaken in specific sports, the negative trends depicted indicate the importance of tracking more than one domain of physical activity. This is reiterated in the findings of Kierkegaard et al [154], with the lack of agreement between objective and subjective reports of activity change. Only a quarter of the studies reported on the activity profile of participants, although information about the type of activity undertaken would be of value in identifying potential barriers and facilitators to physical activity participation post-arthroscopy.…”

“…One study [154] reported objective measures of physical activity utilising accelerometry. The majority (n = 99, 83%) presented the Hip Outcome Score-sportspecific subscale (HOS-SS, Fig.…”

“…Significant decreases were reported in running mileage [95] (P < 0.001) and sport frequency [124] preinjury to post-arthroscopy. Kierkegaard et al [154] identify a self-reported four-fold increase in hours of physical activity per week but no significant differences were reported for accelerometry-derived activity data such as the percentage of time spent in undertaking moderate or high physical activity, step count or percentage of time running between pre-arthroscopy and 1-year postarthroscopy (Additional file 4).…”

Patient-reported outcomes, hip muscle strength and physical activity in patients with femoroacetabular impingement syndrome before and after surgery (PhD Academy Award)

“…My PhD included studies on patients with femoroacetabular impingement syndrome (FAIS). We performed (1) a systematic review with meta-analysis1 investigating patient-reported outcomes before and after hip arthroscopic surgery in patients with FAIS; and (2) a cohort study in which I investigated patient-reported outcomes, hip muscle strength and physical activity level in 60 patients with FAIS before and after hip arthroscopic surgery 2–5…”

“…The cohort study was conducted at Horsens Regional Hospital and Aarhus University in Denmark, where I tested all patients in an isokinetic dynamometer (figure 1)3 4 and attached accelerometers to their thigh in order to monitor daily activity level for 5 days 5. Patient-reported outcomes were collected using the Copenhagen Hip and Groin Outcome Score (HAGOS) 2.…”