Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2‐year follow‐up

Sansone, Mikael; Ahldén, Mattias; Jonasson, Peter; Thomeé, Christoffer; Swärd, Leif; Öhlin, Axel; Baranto, Adad; Karlsson, Jón; Thomeé, Roland

doi:10.1111/sms.12641

Cited by 60 publications

(68 citation statements)

References 23 publications

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“…The values obtained were similar to outcomes after hip arthroscopy for FAI 1,8–10,33,42 and were expectedly higher for those who returned to sport (see Table 2). The most satisfying correlation was between coping mechanisms and specific patient responses on their individual pathway to return to sport.…”

Section: Discussionsupporting

confidence: 62%

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

Tjong

Cogan

Riederman

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Hip arthroscopy for femoroacetabular impingement (FAI) is known to produce excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semistructured patient interviews on patients with hip labral tears.Purpose:To understand the factors influencing the decision to return to sport after arthroscopic hip surgery for FAI.Study Design:Case series; Level of evidence, 4.Methods:An experienced interviewer conducted qualitative, semistructured interviews of patients aged 18 to 60 years who had arthroscopic hip surgery for FAI. All had preinjury participation in sport and a minimum 2-year follow-up with no revision surgery. Qualitative analysis was then performed to derive codes, categories, and themes. An assessment of preinjury and current sports participation by type, level of competition, and frequency along with patient-reported hip function was also obtained. In addition, current modified Harris Hip Score (mHHS), international Hip Outcome Tool (iHOT-12), Hip Outcome Score–sports-specific subscale (HOS-SSS), and a coping mechanism evaluation (Brief COPE) were also recorded.Results:A total of 23 patients were interviewed to reveal the overarching themes of internal motivation, external encouragement, and resetting expectations as the predominant factors influencing a patient’s decision to return to preinjury sport. Subjective outcome measurements (mHHS, iHOT-12, patient satisfaction) showed significant differences between patients who did and did not return to sport. Interestingly, the adaptive and maladaptive coping mechanisms matched and supported our themes in those patients who described fear and self-motivation as defining features influencing their cessation of or return to play, respectively.Conclusion:Self-motivation, aging, pain, encouragement from others, and adapting to physical limitations can largely affect a patient’s decision to return to sport after arthroscopic hip surgery for FAI. Innate coping mechanisms may also help to predict the course of and subsequently aid in a patient’s postoperative recovery.

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Section: Discussionsupporting

confidence: 62%

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

Tjong

Cogan

Riederman

et al. 2016

Orthopaedic Journal of Sports Medicine

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“…Our two groups appear to be representative with regard to their HAGOS scores when compared to previous research with similar populations [19,24,25].…”

Section: Discussionsupporting

confidence: 57%

Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls

Wörner

Sigurðsson

Pålsson

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal MethodsNineteen patients with long-standing hip and groin pain and 19 healthy, activity level-, age-, gender-, and weight-matched controls were assessed with the HAGOS for self-reported outcomes, and a parallel squat (w/kg), single leg triple jump (cm), single leg rise (n), barbell roll-out (% of height), and plank-test (s) for performance-based measures. Independent sample t-test was performed to assess between-group differences. The paired t-test was used to analyze betweenlimb differences in unilateral performance tasks. ResultsThe patients had worse scores than the controls in all HAGOS-subscales (p ≤ 0.001), while no statistically significant differences were observed for any performance measure between groups or between symptomatic and non-symptomatic limbs. ConclusionsDespite significant self-reported functional limitations on the HAGOS, there were no significant differences between groups in performance-based strength or power measures. The results of this study highlight the need to identify performance-based measures, sensitive to functional deficiencies in patients with long-standing hip and groin pain in order to complement the clinical picture obtained by patient-reported outcomes such as the HAGOS.Case-control, Level of evidence III

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“…In the past decade, arthroscopic hip surgery has become the standard surgical therapy for FAI (8,(16)(17)(18)(19). A recent study on arthroscopic treatment of FAI (20) reported that 82% of patients (236 of 289 patients) were satisfied with the surgical result after 2 years.…”

Section: Resultsmentioning

confidence: 99%

Arthroscopic Hip Surgery: Frequency of Postoperative MR Arthrographic Findings in Asymptomatic and Symptomatic Patients

et al. 2017

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Purpose To determine and compare the frequency of imaging abnormalities in asymptomatic and symptomatic patients after arthroscopic hip surgery. Materials and Methods This study was approved by the institutional review board. Informed consent was obtained from all patients. Thirty-four patients (17 asymptomatic and 17 symptomatic patients) underwent 1.5-T magnetic resonance (MR) arthrography of the hip 1 year after arthroscopic treatment of femoroacetabular impingement. Two readers independently analyzed all MR arthrographic images for the presence of abnormal imaging findings, including capsular adhesions at the femoral neck, obliteration of the paralabral sulcus, labral defects, and defects of the hip capsule in several anatomic positions (anterior to posterior). Postoperative findings were compared with linear and generalized linear mixed-effects regression models. Results Capsular adhesions at the anterior femoral neck were present in 12 of the 34 patients (35%), and there were no differences between the groups or readers (P = .99). The paralabral sulcus was obliterated in at least one anatomic location in 94% (reader 1, 32 of 34 patients) and 100% (reader 2, 34 of 34 patients) of patients (P = .99). Residual labral tears were detected in 35% of asymptomatic patients (six of 17 patients) and 41% of symptomatic patients (seven of 17 patients) by reader 1 and in 53% of asymptomatic and symptomatic patients (nine of 17 patients in each group) by reader 2, without significant differences between the groups (P = .81). Defects of the hip capsule were more common in asymptomatic patients (77% [13 of 17 patients] for reader 1 and 53% [nine of 17 patients] for reader 2) than in symptomatic patients (59% [10 of 17 patients] for reader 1 and 47% [eight of 17 patients] for reader 2), but without significant differences (P = .33). Conclusion Obliteration of the paralabral sulcus was the most frequent finding after arthroscopic hip surgery in both asymptomatic and symptomatic patients, and capsular adhesions at the anterior femoral neck were present in 35% of patients in both groups. RSNA, 2016.

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Outcome after hip arthroscopy for femoroacetabular impingement in 289 patients with minimum 2‐year follow‐up

Cited by 60 publications

References 23 publications

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

A Qualitative Assessment of Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement

Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls

Arthroscopic Hip Surgery: Frequency of Postoperative MR Arthrographic Findings in Asymptomatic and Symptomatic Patients

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