Outcome of Hip Impingement Surgery: Does Generalized Joint Hypermobility Matter?

Naal, Florian D.; Müller, Aileen; Varghese, Viju Daniel; Wellauer, Vanessa; Impellizzeri, Franco M.; Leunig, Michael

doi:10.1177/0363546516688636

Cited by 17 publications

(13 citation statements)

References 24 publications

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“…Weber et al found that capsular plication in athletes may actually impair RTS by limiting the external rotation necessary for complex sports [43]. On the contrary, studies have also shown no significant relationship between Beightons scores and functional outcomes following hip arthroscopy [44,45]. It seems that patients with greater internal or external rotation have increased joint instability that may preclude them from returning to their sport.…”

Section: Discussionmentioning

confidence: 99%

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up

Maldonado

Yelton

Rosinsky

et al. 2020

BMC Musculoskelet Disord

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Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting patient reported outcomes (PROs) and return to sport (RTS) in competitive or recreational tennis players after arthroscopic hip surgery. Therefore, the purpose of the present study was to (1) report minimum fiveyear PROs and RTS in tennis players who underwent arthroscopic hip surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement and labral tears between March 2009 and January 2014 and who played tennis within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% RTS rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS.

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Section: Discussionmentioning

confidence: 99%

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up

Maldonado

Yelton

Rosinsky

et al. 2020

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…(40) On the contrary, studies have also shown no significant relationship between Beightons scores and functional outcomes following hip arthroscopy. (41,42) It seems that patients with greater internal or external rotation have increased joint instability that may preclude them from returning to sport.…”

Section: Discussionmentioning

confidence: 99%

Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

Maldonado

Yelton

Rosinsky

et al. 2019

Preprint

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Background: Playing tennis is associated with various movements that can lead to labral injuries and may require arthroscopic surgery. While hip arthroscopies have demonstrated good outcomes in athletes, there is limited literature reporting Patient Reported Outcomes (PROs) and return to play in competitive or recreational tennis players after hip arthroscopic surgery. Therefore, the purpose of the present study was to (1) report minimum five-year PROs and return to sport in tennis players who underwent hip arthroscopic surgery and (2) compare outcomes between recreational and competitive tennis players. Methods: Data for patients who underwent hip arthroscopy surgery in the setting of femoroacetabular impingement (FAI) and labral tears between March 2009 and January 2014 and who played tennis at any level within one-year of surgery were retrospectively reviewed. Patients with preoperative and minimum five-year postoperative scores for the following PROs were included: modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS) for pain. Patients with preoperative Tönnis osteoarthritis Grade >1, Workers’ Compensation claims, age > 60 years old, or previous ipsilateral hip surgeries or conditions were excluded. Patient Acceptable Symptomatic State (PASS) and Minimal Clinically Important Difference (MCID) for mHHS and HOS-SSS were calculated. Results: Of 28 patients, 31 hips met all inclusion and exclusion criteria of which 28 (90.3%) had minimum 5-year follow-up (mean: 72.8 ± 13.9 months). There were 3 professional, 3 collegiate, 2 high school, 2 organized amateur, and 18 recreational level tennis players. All PROs significantly improved at latest follow-up: mHHS from 67.0 to 86.7 (P < 0.001), NAHS from 65.9 to 87.2 (P < 0.001), HOS-SSS from 50.0 to 77.9 (P = 0.009), and VAS from 5.4 to 1.8 (P < 0.001). There was a 75.0% return to sport rate. Additionally, 66.7% of patients achieved MCID and 83.3% achieved PASS for mHHS, and 63.6% achieved MCID and 58.3% achieved PASS for HOS-SSS. Conclusion: Regardless of the level of participation, tennis players who underwent hip arthroscopic surgery reported statistically significant PRO improvements. A favorable rate of return to sport was also achieved.

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“…The Breighton scale is commonly used to quantify the degree of soft tissue laxity in the clinical setting. 27 Patients with hypermobility often carry the diagnosis of Ehlers-Danlos syndrome or other conditions with increased soft tissue laxity and can have significant hip-related symptoms. 28 Anterior impingement is reproduced with the hip in maximal flexion, internal rotation, and adduction.…”

Section: Physical Examinationmentioning

confidence: 99%

Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

et al. 2018

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Borderline hip dysplasia and acetabular retroversion are common radiographic findings in young individuals with and without hip pain. Orthopaedic surgeons should be knowledgeable about the radiographic findings, diagnosis, and appropriate nonsurgical and surgical treatment of these conditions. Borderline hip dysplasia is generally defined by a lateral center edge angle of Wiberg from 20 to 25° (some define as 18–25°) and is a cause of joint microinstability. The degree of soft tissue laxity can have significant implications for joint stability in patients with borderline hip dysplasia. The most common presenting symptoms are groin pain and lateral hip pain. Acetabular retroversion is defined by radiographic findings of crossover sign, ischial spine sign, and posterior wall sign. Individuals with symptomatic retroversion have a clinical presentation consistent with impingement, groin pain with flexion activities, and less commonly lateral hip pain. Physical therapy has been shown to improve symptoms in a subset of individuals with these conditions. There are multiple recent publications about arthroscopic treatment of patients with borderline hip dysplasia. These reports generally find that good short-term outcomes can be expected when using arthroscopic techniques that include labral preservation/repair and capsular plication. There are limited reports of periacetabular osteotomy as a treatment for borderline hip dysplasia. Publications focusing specifically on surgical treatment of acetabular retroversion are also infrequent. Periacetabular osteotomy has been shown to have superior long-term clinical outcomes to surgical hip dislocation with anterior rim trimming in patients with all three radiographic findings of retroversion. Arthroscopic treatment has been shown to have good short-term outcomes. Future work in the areas of borderline hip dysplasia and acetabular retroversion should focus on reporting long-term clinical follow-up of these surgical treatments and using computation techniques as a tool to determine appropriate surgical and nonsurgical treatment for each individual patient.

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Outcome of Hip Impingement Surgery: Does Generalized Joint Hypermobility Matter?

Cited by 17 publications

References 24 publications

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up

Return to play after hip arthroscopy among tennis players: outcomes with minimum five-year follow-up

Return to Play After Hip Arthroscopy Among Tennis Players: Outcomes with Minimum Five-Year Follow-up

Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

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