High or low return to sport rates following hip arthroscopy is a matter of definition?

Wörner, Tobias; Thorborg, Kristian; Stålman, Anders; Webster, Kate E.; Olsson, Hanna Momatz; Eek, Frida

doi:10.1136/bjsports-2018-099154

Cited by 21 publications

(35 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Importantly, our results represent players active on an elite level of play, thereby excluding all players that may have ceased their ice hockey participation due to hip problems such as FAIS. Since approximately half of all patients undergoing FAIS surgery are expected to return to their pre-injury level of sport participation [ 14 , 34 ], the proportion of players reporting history of surgery in this study may underestimate the burden of intra-articular hip problems leading to surgical interventions in ice hockey players.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position

Wörner

Thorborg

Eek

2019

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

Purpose The prevalence of hip and groin problems in professional male ice hockey is unknown and suspected to differ between playing positions. The purpose of this study was to explore potential differences in the seasonal prevalence of hip and groin problems between playing positions in male elite ice hockey players and to explore the relationship between symptom duration and hip and groin function at the beginning of the new season. Methods Male ice hockey players [n = 329 (92 goalkeepers, 93 defensemen, 144 forwards), Mean age (SD): 24 (5)] from the professional leagues in Sweden responded to an online survey. The survey assessed presence of hip and groin problems (time loss and non-time loss) and symptom duration (categorized into 0, 1–6, or > 6 weeks) in the previous season, and current self-reported hip and groin function (Copenhagen Hip and Groin Outcome Score). Results During the previous season, 175 players (53.2%) had experienced hip and groin problems. Non time loss problems were experienced by 158 (48%) and time loss problems were experienced by 97 (29.5%) players. No significant differences between playing positions were found. Self-reported function differed significantly between players with different symptom duration and more disability was reported among players with longer symptom duration (p ≤ 0.002). Conclusion Regardless of playing position, hip and groin problems were prevalent in male ice hockey players. Players with hip and groin problems during the previous season had significantly worse hip and groin function in the beginning of the new season, and longer symptom duration was associated with more disability. Level of evidence III

show abstract

Section: Discussionmentioning

confidence: 99%

High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position

Wörner

Thorborg

Eek

2019

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most patients seeking intervention for hip-related pain wish to return at least to their preinjury physical activity level, which may include sport level and/or performance, and/or occupational demands. For young and middle-aged active adults, this is often one of the reasons they seek help in managing their condition 33–36. Management success (both non-surgical and surgical) may be defined by the patient’s ability to achieve their preintervention sport or physical activity goals.…”

Section: Discussionmentioning

confidence: 99%

“…Definitions used in studies examining RTS following management of hip-related pain often consider RTS as a dichotomous variable (yes/no) and fail to distinguish between the differing levels of RTS or consider whether the athlete has successfully returned to their preinjury sporting performance 56. Two recent studies have applied this graded definition, providing a more nuanced picture of RTS expectations for patients following hip arthroscopy 33 35. The 2016 consensus statement on RTS introduced the concept of RTS being considered a continuum through which an athlete progresses during the rehabilitation process 34.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, there is limited to moderate evidence that one in four athletes did not return to their previous level of sport participation after surgery for FAI syndrome 56. Data from recent cross-sectional surveys of athletes afterhip arthroscopy suggest that the percentage of athletes returning to their preinjury level of sport with optimal performance could actually be as low as 17% 33 35. In general, poor outcome reporting on athletic performance after surgery makes it difficult to determine the actual sporting performance these athletes return to 56.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018

et al. 2019

Self Cite

View full text Add to dashboard Cite

Hip-related pain can significantly impact quality of life, function, work capacity, physical activity and family life. Standardised measurement methods of physical capacity of relevance to young and middle-aged active adults with hip-related pain are currently not established. The aim of this consensus paper was to provide recommendations for clinical practice and research on standardised measurement methods of physical capacity in young and middle-aged active adults with hip-related pain. Four areas of importance were identified: (1) clinical measures (range of motion, muscle strength, functional impairments), (2) laboratory-based measures (biomechanics and muscle function (muscle activity, size and adiposity)), (3) physical activity, and (4) return to sport/performance. The literature was reviewed, and a summary circulated to the working group to inform discussion at the consensus meeting. The working group developed clinical and research recommendations from the literature review, which were further discussed and modified within the working group at the consensus meeting. These recommendations were then presented to all 38 International Hip-related Pain Research Network (IHiPRN) participants for further discussion, refinement and consensus voting. Therefore, the recommendations voted on were based on a combination of current evidence and expert opinion. The consensus meeting voted on 13 recommendations, six of which were clinically orientated, and seven more research specific. We recommended that clinicians working with young and middle-aged active adults with hip-related pain assess strength using objective methods of measurement, and clinically assess performance of functional tasks, including walking and running. Physical activity should be quantified using both self-reported and objective measures, and patient expectations of recovery should be quantified prior to treatment. It was recommended that return to physical activity (including sport and occupation) be quantified, and sport-specific activities should be assessed prior to return to sport. The IHiPRN participants were uncertain regarding recommendations for range of motion assessment. Research recommendations were that the measurement properties of range of motion, strength and functional performance tests be investigated, reported and improved in both clinical and research settings. Reporting of movement-related parameters (biomechanics and muscle function) should be standardised and the relationship among movement-related parameters, symptoms, function, quality of life, and intra-articular and imaging findings should be investigated. Quantification of return to physical activity (including sport and occupational demands) is required in future research, and the return to sport continuum should be used. Future research is required to determine the best criteria for rehabilitation progression and return to physical activity following hip-related pain management.

show abstract

“…26 However, despite high rates of return to general sports participation, 33 recent studies have reported that only approximately half of all athletes return to their previous sports and that just 1 in 5 return to previous performance levels. 15,49 Furthermore, patients often present with residual hip pain and reduced self-reported sporting function after HA. 19,40 More knowledge regarding the functional performance of patients who have undergone HA is needed to identify impairments that may be responsible for reduced self-reported sporting function and low rates of return to performance.…”

mentioning

confidence: 99%

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

Nilsson

Thorborg

et al. 2019

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

Background: Little is known about hip-related function, mobility, and performance in patients after hip arthroscopic surgery (HA) during the time that return to sports can be expected. Purpose: To evaluate measures of subjective and objective hip function 6 to 10 months after HA in patients compared with healthy controls and to compare objective function in the HA group between the operated and nonoperated hips. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 33 patients who had undergone HA (mean, 8.1 ± 2.6 months postoperatively) and 33 healthy participants matched on sex, age, and activity level were compared regarding subjective hip function (Copenhagen Hip and Groin Outcome Score [HAGOS]) and objective function including hip range of motion (ROM; flexion, internal rotation, and external rotation), isometric hip muscle strength (adduction, abduction, flexion, internal rotation, and external rotation), and performance-based measures: the Y Balance Test (YBT), medial and lateral triple-hop test, and Illinois agility test. Group differences were analyzed using independent-samples t tests. Paired-samples t tests were used for a comparison of the operated and nonoperated hips. Standard effect sizes (Cohen d ) were provided for all outcomes. Results: The HA group reported worse subjective hip function than the control group (HAGOS subscores: d = –0.7 to –2.1; P ≤ .004). Objective measures of hip ROM ( d = –0.5 to –1.1; P ≤ .048), hip flexion strength ( d = –0.5; P = .043), and posteromedial reach of the YBT ( d = –0.5; P = .043) were also reduced in the HA group, although there were no significant differences between groups regarding the remaining objective measures ( d = –0.1 to –0.4; P ≥ .102 to .534). The only significant difference between the operated and nonoperated hips in the HA group was reduced passive hip flexion ( d = –0.4; P = .045). Conclusion: Patients who had undergone HA demonstrated reduced subjective hip function compared with controls 6 to 10 months after surgery, when return to sports can be expected. While most objective strength and performance test results were comparable between the HA and control groups at 6 to 10 months after surgery, the HA group presented with impairments related to hip mobility and hip flexion strength. No consistent pattern of impairments was found in operated hips compared with nonoperated hips.

show abstract

High or low return to sport rates following hip arthroscopy is a matter of definition?

Cited by 21 publications

References 6 publications

High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position

High prevalence of hip and groin problems in professional ice hockey players, regardless of playing position

Standardised measurement of physical capacity in young and middle-aged active adults with hip-related pain: recommendations from the first International Hip-related Pain Research Network (IHiPRN) meeting, Zurich, 2018

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

Contact Info

Product

Resources

About