High Rate of Return to High-Intensity Interval Training After Arthroscopic Management of Femoroacetabular Impingement Syndrome

Riff, Andrew J.; Ukwuani, Gift; Clapp, Ian M.; Movassaghi, Kamran; Kelly, David M.; Nho, Shane J.

doi:10.1177/0363546518776638

Cited by 24 publications

(43 citation statements)

References 13 publications

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“…Ten papers were identified from the two journals that met the inclusion criteria. Of those ten papers, two reported results at both 1 year and 2 years and were counted as separate studies for the analysis, resulting in a total of 12 studies [7, 8, 10, 11, 16, 19, 31, 32, 35, 38].…”

Section: Resultsmentioning

confidence: 99%

Reporting Clinical Significance in Hip Arthroscopy: Where Are We Now?

et al. 2020

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Background Although p values are standard for reporting statistical significance of patient-reported outcome measures (PROMs), the shift toward clinically important outcome values, including minimal clinically important difference (MCID) and substantial clinical benefit (SCB), necessitates re-evaluation of the current literature. Questions/Purposes We sought to answer two questions regarding studies on primary hip arthroscopy performed for the treatment of femoroacetabular impingement syndrome (FAIS). (1) Do such studies reporting statistical significance on common PROMs meet published MCID/SCB thresholds? (2) What proportion of such studies report both statistical and clinical significance? Methods We identified four papers published in two journals defining MCID/SCB values on the modified Harris Hip Score (mHHS), Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sport (HOS-Sport), international Hip Outcome Tool (iHOT-33), and its short version (iHOT-12) for different groups of FAIS patients undergoing hip arthroscopy. We reviewed these two journals from the dates of publication to the present to identify papers reporting changes in post-operative PROMs. The difference in pre- and post-operative scores on each PROM was calculated and compared to MCID/SCB thresholds. Results Twelve studies were included. Ten studies (83%) evaluated mHHS (90% met MCID, 50% met SCB), seven (58%) evaluated HOS-ADL (100% met MCID/SCB) and HOS-Sport (100% met MCID, 57% met SCB), and one (8%) evaluated iHOT-33 (met MCID/SCB) and iHOT-12 (met MCID). Most studies met MCID and SCB at both 1- and 2-year timepoints. Of the studies evaluated, 50% reported clinical relevance. Conclusions Nearly all studies evaluated met MCID, while fewer met SCB. Only half discussed these clinical measures. It is proposed that all future studies report both statistical and clinical significance as standard best practice.

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Section: Resultsmentioning

confidence: 99%

Reporting Clinical Significance in Hip Arthroscopy: Where Are We Now?

et al. 2020

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“…Closure of the capsulotomy site via repair of the interportal and T-capsulotomy incisions was performed in all cases. 12,42 Hip traction was released immediately after work was concluded in the central compartment, and a dynamic examination was then performed to confirm the resolution of impingement. Labral refixation was performed when gross detachment of the labrum from the acetabular rim was observed; otherwise, partial debridement was used for patients with sufficient labral tissue and little or no detachment.…”

Section: Methodsmentioning

confidence: 99%

“…Rehabilitation started on postoperative day 1 for all patients regardless of their athletic status and has been described previously in the literature. 42 Patients went through a 4-phase rehabilitation protocol that lasted a mean of 16 to 18 weeks. Phase 1 prioritized joint protection and soft tissue mobilization techniques.…”

Section: Methodsmentioning

confidence: 99%

Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis

Frank

Kunze

Beck

et al. 2019

Orthopaedic Journal of Sports Medicine

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Background:Female patients undergoing surgery for femoroacetabular impingement syndrome (FAIS) often experience inferior clinical outcomes and higher failure rates when compared with male patients. The influence of athletic status on hip arthroscopic outcomes in female patients, however, is unclear.Purpose:To compare patient-reported outcomes (PROs) of athletic and nonathletic female patients undergoing hip arthroscopic surgery for FAIS, and to determine the return-to-sports rate in the athlete group.Study Design:Cohort study; Level of evidence, 3.Methods:Two-year PROs were assessed in female patients who had undergone hip arthroscopic surgery for FAIS by a single surgeon. Patients who self-identified as athletes were compared with nonathletes. Preoperative and postoperative PRO scores including the Hip Outcome Score–Activities of Daily Living (HOS-ADL), Hip Outcome Score–Sport-Specific (HOS-SS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction were analyzed and compared between athletes and nonathletes. Subanalysis was performed based on patient age and body mass index (BMI).Results:A total of 330 female patients undergoing hip arthroscopic surgery for FAIS were identified. Of these, 221 patients identified as athletes (mean age, 29.1 ± 11.1 years; mean BMI, 23.0 ± 3.5 kg/m2) and 109 as nonathletes (mean age, 39.3 ± 11.4 years; mean BMI, 27.8 ± 5.8 kg/m2). Both groups demonstrated improvements in HOS-ADL, HOS-SS, mHHS, VAS for pain, and VAS for satisfaction scores (P < .001 for all). Athletes had significantly higher postoperative PRO scores compared with nonathletes (P < .001 for all). A 1:1 matched-pair subanalysis of 97 athletes and 97 nonathletes controlling for age and BMI indicated that these relationships held independently of potential demographic confounders (P < .001 for all). The number of patients meeting the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for the HOS-ADL, HOS-SS, and mHHS was significantly higher in athletes aged ≤25 years versus those aged >25 years and for athletes versus nonathletes (P < .05 for all). Further, 189 of 194 athletes returned to sports at a mean of 6.0 ± 3.9 months postoperatively, with 93.7% reporting returning to the same or higher level of competition.Conclusion:Among female patients undergoing hip arthroscopic surgery for FAIS, patients considered athletes achieved superior clinical outcomes compared with patients considered nonathletes. In addition, younger female athletes had higher rates of achieving the MCID and PASS for all PRO measures.

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“…Four articles in this month's American Journal of Sports Medicine examine the ability of arthroscopic hip surgery to return patients to athletic participation at levels ranging from recreational to specialized professional competition. The first of these focuses on high-intensity interval training (HIT), 24 an activity that currently enjoys a level of popularity approaching reverence among fitness fanatics. In most studies of injuries in HIT aficionados, the average participant is a 30-something 2,13,29 who works out 4 or more times per week.…”

mentioning

confidence: 99%

“…13,29,31 Hip and groin injuries are not particularly common in this population, usually trailing shoulder, back, and knee complaints in prevalence. 2,13,31 Nevertheless, Riff and colleagues 24 were able to report a minimum of 2 years' followup on 32 HIT enthusiasts after arthroscopic management of femoroacetabular impingement (FAI). Preoperative complaints were severe enough that all except 1 subject had discontinued (n = 14) or reduced (n = 17) their participation.…”

mentioning

confidence: 99%

High Hopes for Hips

Reider¹

2018

Am J Sports Med

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High Rate of Return to High-Intensity Interval Training After Arthroscopic Management of Femoroacetabular Impingement Syndrome

Cited by 24 publications

References 13 publications

Reporting Clinical Significance in Hip Arthroscopy: Where Are We Now?

Reporting Clinical Significance in Hip Arthroscopy: Where Are We Now?

Do Female Athletes Return to Sports After Hip Preservation Surgery for Femoroacetabular Impingement Syndrome?: A Comparative Analysis

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