scholarly journals The 2019 International Society of Hip Preservation (ISHA) physiotherapy agreement on assessment and treatment of femoroacetabular impingement syndrome (FAIS): an international consensus statement

2021 ◽  
Author(s):  
Amir Takla ◽  
John O'Donnell ◽  
Michael Voight ◽  
Thomas Byrd ◽  
Michael Dienst ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
International Society ◽  
Consensus Statement ◽  
Return To Sport ◽  
Operative Management ◽  
Impingement Syndrome ◽  
Return To Sports ◽  
International Consensus ◽  
Extensive Experience ◽  
Femoroacetabular Impingement Syndrome

Abstract The 2019 International Society of Hip Preservation (ISHA) physiotherapy agreement on femoroacetabular impingement syndrome (FAIS) was intended to build an international physiotherapy consensus on the assessment, non-surgical physiotherapy treatment, pre-/post-operative management, and return to sport decisions for those patients with FAIS. The panel consisted of 11 physiotherapists and 8 orthopaedic surgeons. There is limited evidence regarding the use of physiotherapy in the overall management of those with FAIS. Therefore, a group of ISHA member physiotherapists, who treat large numbers of FAIS patients and have extensive experience in this area, constructed a consensus statement to guide physiotherapy-related decisions in the overall management of those with FAIS. The consensus was conducted using a modified Delphi technique. Six major topics were the focus of the consensus statement: (i) hip assessment, (ii) non-surgical physiotherapy management, (iii) pre-habilitation prior to hip arthroscopy, (iv) post-operative physiotherapy rehabilitation, (v) stages of post-operative rehabilitation and (vi) return to sports criteria/guidelines after surgery.

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

2019 ◽  
Vol 7 (3) ◽  
pp. 232596711983175 ◽  
Author(s):  
Rachel M. Frank ◽  
Kyle N. Kunze ◽  
Edward C. Beck ◽  
William H. Neal ◽  
Charles A. Bush-Joseph ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Femoroacetabular Impingement ◽  
Female Athletes ◽  
Impingement Syndrome ◽  
Return To Sports ◽  
Femoroacetabular Impingement Syndrome

Can We Identify Why Athletes Fail to Return to Sport After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Systematic Review and Meta-analysis

2020 ◽  
pp. 036354652095629
Author(s):  
Alexander E. Weber ◽  
Ioanna K. Bolia ◽  
Cory K. Mayfield ◽  
Hansel Ihn ◽  
Hyunwoo P. Kang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Return To Sport ◽  
Improve Patient Care ◽  
Hip Pain ◽  
Impingement Syndrome ◽  
Femoroacetabular Impingement Syndrome ◽  
High Level

Background: No previous systematic review has focused on the athletes who fail to return to sport after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Purpose: To review the literature on the athletes who fail to return to sport after hip arthroscopy for FAIS to determine the rate of nonreturning athletes and explore the reasons for their inability to return to sport after arthroscopic FAI surgery. Study Design: Systematic review and meta-analysis. Methods: Three electronic databases were searched for eligible articles. Two reviewers independently screened the titles, abstracts, and full-text articles using prespecified criteria. Eligible articles were those that clearly stated the rate of athletes who did not return to sport after hip arthroscopy for FAIS. Data collected were the rate of patients who did not return to sport, the level of competition (high level, recreational, or mixed), the type of sport, comments on patients who did not return to sport, the rate of subsequent hip surgeries (total hip replacement or revision hip arthroscopy) in nonreturning athletes, and the reported reason for not returning to sport. A random-effects model was used for meta-analysis. Results: Twenty studies were eligible for inclusion, and 1093 athletes were analyzed. The weighted rate of athletes who did not return to sport after hip arthroscopy for FAIS was 12.1% (95% CI, 7.7-17.4). Only 2 studies (2/20;10%) reported the age of the athletes who did not return, while sex was reported in 3 studies (3/20;15%). The estimated proportion of athletes who did not return to sport because of hip-related issues was significantly greater than the percentage of athletes who did not return for reasons unrelated to their hip (74.3% vs 22.3%; P < .0001). Persistent hip pain was the most commonly reported factor (52/110 patients; 47.2%) associated with failure to return to sport. Whether the nonreturning athletes underwent any subsequent hip procedure after hip arthroscopy for FAIS was reported in only 4 out of 20 studies (20%). There was evidence of publication bias and study heterogeneity. Conclusion: The estimated rate of athletes who did not return to sport after hip arthroscopy for FAIS was 12%, with the majority of athletes being unable to return because of persistent hip pain. There is a severe lack of evidence on the athlete characteristics and clinical course of the nonreturning athletes, and the rate of subsequent hip procedures is unknown. The outcomes and reasons for athletes not returning to sport should be reported in detail to improve patient care.

Return to Sport and Performance After Hip Arthroscopy for Femoroacetabular Impingement in 18- to 30-Year-Old Athletes: A Cross-sectional Cohort Study of 189 Athletes

2018 ◽  
Vol 46 (11) ◽  
pp. 2578-2587 ◽  
Author(s):  
Lasse Ishøi ◽  
Kristian Thorborg ◽  
Otto Kraemer ◽  
Per Hölmich
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Return To Sport ◽  
Sports Participation ◽  
Impingement Syndrome ◽  
Sports Performance ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Femoroacetabular Impingement Syndrome

Background: A recent systematic review found that 87% of athletes return to sport after hip surgery for femoroacetabular impingement syndrome. However, the proportion of athletes returning to preinjury sport at their preinjury level of sport is less clear. Purpose: The main purpose of this study was to determine the rate of athletes returning to preinjury sport at preinjury level including their associated sports performance after hip arthroscopy for femoroacetabular impingement syndrome. Furthermore, self-reported hip and groin function was investigated. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Eligible subjects were identified in the Danish Hip Arthroscopy Registry. A self-reported return to sport questionnaire was used to collect data after hip arthroscopy. If athletes reported they were engaged in preinjury sport at their preinjury level, the associated sports performance and participation were assessed as either (1) optimal sports performance including full sports participation; (2) impaired sports performance, but full sports participation; or (3) impaired sports performance including restricted sports participation. Self-reported hip and groin function was assessed for all athletes by use of the Copenhagen Hip and Groin Outcome Score. Results: The study included 189 athletes (mean ± SD age at follow-up, 26.9 ± 3.4 years) at a mean ± SD follow-up of 33.1 ± 16.3 months after surgery. At follow-up, 108 athletes (57.1%) were playing preinjury sport at preinjury level, whereas the remaining 81 athletes (42.9%) failed to return to preinjury sport at preinjury level. Of the 108 athletes engaged in their preinjury sport at preinjury level at follow-up, 32 athletes (29.6%) reported optimal sports performance including full sports participation, corresponding to 16.9% of the study sample. Better self-reported hip and groin function was observed in athletes who were engaged in preinjury sport at preinjury level compared with athletes who were not. Conclusion: Fifty-seven percent of athletes returned to preinjury sport at their preinjury level. This is considerably lower than a previously reported return to sport rate of 87% and may reflect that the present study used a clear and strict definition of return to sport. Of note, only one-third of athletes who returned to preinjury sport at preinjury level reported their sports performance to be optimal, corresponding to 16.9% of the study sample. Better self-reported hip and groin function was observed in athletes who were playing preinjury sport at preinjury level compared with athletes who were not.

scholarly journals Return to Sport and Athletic Function in an Active Population After Primary Arthroscopic Labral Reconstruction of the Hip

2020 ◽  
Vol 8 (2) ◽  
pp. 232596711990076 ◽  
Author(s):  
David R. Maldonado ◽  
Sarah L. Chen ◽  
Mitchell J. Yelton ◽  
Philip J. Rosinsky ◽  
Rafael Walker-Santiago ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Return To Sport ◽  
Impingement Syndrome ◽  
Rate Of Return ◽  
Harris Hip Score ◽  
Labral Tears ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
The Mean

Background: Labral reconstruction has been advocated as an alternative to debridement for the treatment of irreparable labral tears, showing favorable short-term results. However, literature is scarce regarding outcomes and return to sport in the nonelite athletic population. Purpose: To report minimum 1-year clinical outcomes and the rate of return to sport in athletic patients who underwent primary hip arthroscopy with labral reconstruction in the setting of femoroacetabular impingement syndrome and irreparable labral tears. Study Design: Case series; Level of evidence, 4. Methods: Data were prospectively collected and retrospectively analyzed for patients who underwent an arthroscopic labral reconstruction between August 2012 and December 2017. Patients were included if they identified as an athlete (high school, college, recreational, or amateur); had follow-up on the following patient-reported outcomes (PROs): modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), Hip Outcome Score–Sport Specific Subscale (HOS-SSS), and visual analog scale (VAS); and completed a return-to-sport survey at 1 year postoperatively. Patients were excluded if they underwent any previous ipsilateral hip surgery, had dysplasia, or had prior hip conditions. The proportions of patients who achieved the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) for mHHS and HOS-SSS were calculated. Statistical significance was set at P = .05. Results: There were 32 (14 females) athletes who underwent primary arthroscopic labral reconstruction during the study period. The mean age and body mass index of the group were 40.3 years (range, 15.5-58.7 years) and 27.9 kg/m2 (range, 19.6-40.1 kg/m2), respectively. The mean follow-up was 26.4 months (range, 12-64.2 months). All patients demonstrated significant improvement in mHHS, NAHS, HOS-SSS, and VAS ( P < .001) at latest follow-up. Additionally, 84.4% achieved MCID and 81.3% achieved PASS for mHHS, and 87.5% achieved MCID and 75% achieved PASS for HOS-SSS. VAS pain scores decreased from 4.4 to 1.8, and the satisfaction with surgery was 7.9 out of 10. The rate of return to sport was 78%. Conclusion: At minimum 1-year follow-up, primary arthroscopic labral reconstruction, in the setting of femoroacetabular impingement syndrome and irreparable labral tears, was associated with significant improvement in PROs in athletic populations. Return to sport within 1 year of surgery was 78%.

Return to Sport Rates in Physically Active Individuals 6 Months After Arthroscopy for Femoroacetabular Impingement Syndrome

2019 ◽  
Vol 28 (6) ◽  
pp. 570-575 ◽  
Author(s):  
Kathryn R. Glaws ◽  
Thomas J. Ellis ◽  
Timothy E. Hewett ◽  
Stephanie Di Stasi
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Return To Sport ◽  
Time Frame ◽  
Impingement Syndrome ◽  
Physically Active ◽  
Femoroacetabular Impingement Syndrome ◽  
Hip Function ◽  
Over Time

Context: Six months is the expected time frame to return to sport (RTS) after hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Objective: The primary aims of this study were to (1) report the RTS rate of physically active individuals 6 months after arthroscopic surgery for FAIS and (2) compare the self-reported hip function between those who were able to RTS against those who had not. Design: Cohort study. Setting: The Ohio State University Wexner Medical Center. Patients: A total of 42 physically active individuals scheduled for hip arthroscopy for FAIS. Main Outcome Measures: Self-reported function, including preinjury and current activity levels and ability to participate in sport, were collected on 42 individuals with FAIS prior to surgery and at 6-month follow-up. Participants were allocated into 2 groups based on self-reported RTS status at 6-month follow-up. Separate 2-way analyses of variance were used to test the interaction of groups (those who did/did not RTS). Main effects were reported in the absence of statistically significant interactions (P ≤ .05). Results: Altogether, 28 of 42 participants (66%) returned for 6-month follow-up; 5 of the 14 participants (35.7%) lost to follow-up underwent contralateral hip surgery within the study time frame. At the 6-month follow-up, 16 of the remaining 28 participants (57.1%) reported that they had returned to sport, 5 of whom returned at their prior level of participation. There was no statistically significant interaction of group and time for either hip outcome score subscale (P ≥ .20). Self-reported hip function improved over time, regardless of group (P ≤ .001). Participants in the yRTS group demonstrated higher hip outcome score-sport scores than did the nRTS group, regardless of time (P = .04). Conclusions: Though just over half of participants returned to sport 6 months after hip arthroscopy for FAIS, only 18% returned to their previous level of sports participation. Participants who returned to sport reported better function than those who did not, but self-reported hip function improved over time regardless of group. The most commonly reported reasons for not returning to sport were weakness (69.6%), fear (65.2%), and pain (56.5%).

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