scholarly journals Comparable patient-reported outcomes in females with or without joint hypermobility after hip arthroscopy and capsular plication for femoroacetabular impingement syndrome

2019 ◽  
Vol 6 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Austin V Stone ◽  
Nabil Mehta ◽  
Edward C Beck ◽  
Brian R Waterman ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Joint Hypermobility ◽  
Impingement Syndrome ◽  
Capsular Plication ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported

scholarly journals Effect of prior ipsilateral lower extremity surgery on 2-year outcomes following hip arthroscopy for femoroacetabular impingement syndrome

2019 ◽  
Vol 6 (3) ◽  
pp. 241-248
Author(s):  
Kyle N Kunze ◽  
Edward C Beck ◽  
Kelechi R Okoroha ◽  
Jorge Chahla ◽  
Sunikom Suppauksorn ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Patient Reported Outcomes ◽  
Impingement Syndrome ◽  
Prior History ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
History Of ◽  
Clinically Significant

Abstract The purpose of this study was to determine the influence of prior lower extremity surgery on patient reported outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Consecutive patients who underwent hip arthroscopy for FAIS and a prior history of ipsilateral lower extremity surgery were identified and matched 2:1 by age, gender, and body mass index (BMI) to controls without a history of lower extremity surgery. The minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were calculated for HOS–ADL, HOS–SS, and mHHS. Preoperative and 2-year postoperative patient reported outcomes of both groups were compared, and logistic regression was performed to determine whether lower extremity surgery influenced achieving MCID and PASS. A total of 102 patients (24.94%) with prior history of ipsilateral lower extremity surgery were identified. Ipsilateral orthopaedic knee surgery accounted for more than half (53.92%) of all prior surgeries. Patients with a history of ipsilateral lower extremity surgery had significant lower 2-year PROs, satisfaction, and greater pain when compared to patients without lower extremity surgery (P < 0.001 all). A history of ipsilateral lower extremity surgery was a negative predictor of achieving MCID for HOS–ADL and HOS–SS, as well as PASS for HOS–ADL, HOS–SS, and mHHS (P < 0.001 all). In conclusion, patients with prior lower extremity surgery were found to have inferior outcome scores and a lower likelihood of achieving clinically significant outcome improvement compared to patients without a history of lower extremity surgery at two years postoperatively.

scholarly journals Clinically Significant Outcome Improvement After Hip Arthroscopy in Patients With Femoroacetabular Impingement Syndrome and Severe Femoral Torsion

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110345
Author(s):  
Steven F. DeFroda ◽  
Thomas D. Alter ◽  
Blake M. Bodendorfer ◽  
Alexander C. Newhouse ◽  
Felipe S. Bessa ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Impingement Syndrome ◽  
Harris Hip Score ◽  
Femoral Torsion ◽  
Outcome Score ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Outcome Improvement ◽  
Clinically Significant

Background: The influence of femoral torsion on clinically significant outcome improvement after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has not been well-studied. Purpose: To quantify femoral torsion in FAIS patients using magnetic resonance imaging (MRI) and explore the relationship between femoral torsion and clinically significant outcome improvement after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Included were patients who underwent hip arthroscopy for FAIS between January 2012 and August 2018 and had 2-year follow-up and preoperative MRI scans containing transcondylar slices of the knee. Participants were categorized as having severe retrotorsion (SR; <0°), normal torsion (NT; 0°-25°), and severe antetorsion (SA; >25°) as measured on MRI. Patient-reported outcomes (PROs) included the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Subscale, modified Harris Hip Score, 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain and satisfaction. Achievement of Patient Acceptable Symptom State (PASS) and substantial clinical benefit (SCB) were analyzed among cohorts. Results: Included were 183 patients (SR, n = 13; NT, n = 154; SA, n = 16) with a mean age, body mass index, and femoral torsion of 30.6 ± 12.1 years, 24.0 ± 4.4 kg/m2, and 12.55° ± 9.58°, respectively. The mean torsion was –4.5° ± 2.6° for the SR, 12.1° ± 6.8° for the NT, and 31.0° ± 3.6° for the SA group. There were between-group differences in the proportion of patients who achieved PASS and SCB on the iHOT-12, pain VAS, and any PRO ( P < .05). Post hoc analysis indicated that the SA group achieved lower rates of PASS and SCB on the iHOT-12 and pain VAS, and lower rates of PASS on any PRO versus the SR group ( P < .05); the SR group achieved higher rates of PASS and SCB on pain VAS scores versus the NT group ( P = .003). Conclusion: The orientation and severity of femoral torsion during hip arthroscopy influenced the propensity for clinically significant outcome improvement. Specifically, patients with femoral retrotorsion and femoral antetorsion had higher and lower rates of clinically significant outcome improvement, respectively.

scholarly journals No association between femoral or acetabular angles and patient-reported outcomes in patients with femoroacetabular impingement syndrome—results from the HAFAI cohort

2020 ◽  
Vol 7 (2) ◽  
pp. 242-248
Author(s):  
S Kierkegaard ◽  
L Rømer ◽  
B Lund ◽  
U Dalgas ◽  
K Søballe ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Patient Reported Outcomes ◽  
Morphological Changes ◽  
Arthroscopic Surgery ◽  
Alpha Angle ◽  
Clinical Findings ◽  
Impingement Syndrome ◽  
Acetabular Index ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported

Abstract Patients with femoroacetabular impingement syndrome (FAIS) are diagnosed using imaging, but detailed description especially the acetabular shape is lacking and may help give more insight to the pathogenesis of FAIS. Furthermore, associations between patient-reported outcomes (PROs) and the radiological angles might highlight which radiological angles affect outcomes experienced by the patients. Hence, the aims of this study were (i) to describe computer tomography (CT) acquired angles in patients with FAIS and (ii) to investigate the association between radiological angles and the Copenhagen Hip and Groin Outcome Score (HAGOS) in patients with FAIS. Patients scheduled for primary hip arthroscopic surgery for FAIS were included. Based on CT, following angles were measured before and 1 year after surgery; femoral anteversion, alpha, lateral centre edge, acetabular index, anterior sector, posterior sector and acetabular anteversion. All patients completed the HAGOS. Sixty patients (63% females) aged 36 ± 9 were included. One year after surgery, significant alterations in the alpha angle and the acetabular index angle were found. Neither baseline PROs nor changes in PROs were associated with the radiological angles or changes in angles. Since neither changes in CT angles nor baseline scores were associated with HAGOS, the improvements felt by patients must origin from somewhere else. These findings further underlines that morphological changes seen at imaging should not be treated arthroscopically without a patient history of symptoms and clinical findings.

scholarly journals Return to Pilates following hip arthroscopy for treatment of femoroacetabular impingement syndrome

2019 ◽  
Author(s):  
Timothy C Keating ◽  
Jorge Chahla ◽  
Edward C Beck ◽  
Andrew J Riff ◽  
Ian M Clapp ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Demographic Data ◽  
Exercise Program ◽  
Patient Reported Outcome ◽  
The Body ◽  
Impingement Syndrome ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Hip Function

Abstract The Pilates Method is a common exercise program which focuses on strength, flexibility and control of the body. While the effects of Pilates have been shown to benefit, limited research has investigated its effect on patients with symptomatic femoroacetabular impingement syndrome (FAIS). As such, the purpose of this study was to examine the rate of return to Pilates following hip arthroscopy after undergoing hip arthroscopy for FAIS. The study evaluated consecutive patients who identified themselves as participating in Pilates and had undergone hip arthroscopy for the treatment of FAIS by a single fellowship-trained surgeon between 2012 and 2015 were reviewed. Demographic data, baseline physical examination, imaging, pre- and postoperative patient-reported outcome scores at a minimum of 2-years following surgery as well as a Pilates-specific questionnaire were assessed for all patients. A total of 25 patients (all female) with mean age 38 ± 11 years were identified. Preoperatively, 12 patients had discontinued Pilates due to activity-related hip complaints, 11 patients had scaled back involvement, and 2 patients maintained their baseline routine. Postoperatively, 23 of 25 patients (92%) returned to Pilates at an average of 7.7 ± 4.2 months following surgery (range, 3–14 months). Postoperatively, 96% returned to Pilates at the same level or better than preinjury. Preinjury and postoperative involvement in Pilates were comparable (2.2 h v. 1.8 h per week, P = 0.8). Loss of interest and fear of reinjury were the most common reasons for reduced Pilates involvement. All patients had significant improvements in HOS-ADL (pre 56.52 ± 21.6; post 86.1 ± 18.8; P < 0.001), HOS-SS (30.1 ± 20.0, 63.8 ± 34.8; P < 0.001), mHHS scores (57.6 ± 12.8; 79.2 ± 19.6; P < 0.001), and VAS pain (68.8 ± 15.4; 21.4 ± 26.5; P < 0.001). In conclusion, arthroscopic treatment of FAIS in Pilates participants resulted in significant improvements in hip function and predictably high rates of satisfaction.

scholarly journals How Many Patients Achieve an Acceptable Symptom State After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Cross-sectional Study Including PASS Cutoff Values for the HAGOS and iHOT-33

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199526
Author(s):  
Lasse Ishøi ◽  
Kristian Thorborg ◽  
Marie G. Ørum ◽  
Joanne L. Kemp ◽  
Michael P. Reiman ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Impingement Syndrome ◽  
Discriminative Ability ◽  
Cutoff Values ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Hip Function ◽  
Cutoff Scores

Background: Hip arthroscopy is a viable treatment for femoroacetabular impingement syndrome (FAIS). Clinically relevant improvements in hip function and pain after surgery are often reported, but it is less clear how many patients achieve an acceptable symptom state (Patient Acceptable Symptom State [PASS]). Purpose: To investigate the proportion of patients who achieved a PASS 12 to 24 months after hip arthroscopy and to determine the cutoff scores of the 2 recommended and valid patient-reported outcome measures (the subscales of the Copenhagen Hip and Groin Outcome Score [HAGOS] and the International Hip Outcome Tool—33 [iHOT-33]) for which patients are most likely to achieve PASS. Study Design: Cohort study; Level of evidence, 3. Methods: Eligible study patients were identified in the Danish Hip Arthroscopy Registry. An electronic questionnaire was used to collect data on PASS, HAGOS, and iHOT-33 12 to 24 months after surgery. PASS was measured using an anchor question. Receiver operating characteristic curve analyses were applied to identify the PASS cutoff values of HAGOS and iHOT-33 scores. Results: A total of 137 individuals (mean age at surgery, 35.4 ± 9.4 years) were included in the study at a mean follow-up of 18.5 ± 3.2 months after surgery. At follow-up, 64 individuals (46.7%; 95% CI, 38.6-55.1) reported PASS. Higher HAGOS and iHOT-33 values were observed for participants who reported PASS compared with those who did not report PASS (Cohen d ≥ 1.06; P < .001). Cutoff scores for HAGOS subscales (42.5-82.5) and iHOT-33 (67.00) showed excellent to outstanding discriminative ability in predicting PASS (area under the curve, 0.82-0.92). Conclusion: In total, 46% of individuals having hip arthroscopy for FAIS achieved PASS at 12 to 24 months of follow-up. Patients who achieved PASS had statistically significant and substantially better self-reported hip function compared with those who did not achieve PASS. Cutoff values at HAGOS subscales and iHOT-33 showed excellent to outstanding discriminative ability in predicting patients with PASS.

scholarly journals High Rate of Return to Yoga for Athletes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome

2018 ◽  
Vol 10 (5) ◽  
pp. 434-440 ◽  
Author(s):  
Rachel M. Frank ◽  
Gift Ukwuani ◽  
Bradley Allison ◽  
Ian Clapp ◽  
Shane J. Nho
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Female Athletes ◽  
Demographic Data ◽  
Impingement Syndrome ◽  
High Rate ◽  
Rate Of Return ◽  
Harris Hip Score ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported

Background: Femoroacetabular impingement syndrome (FAIS) is most commonly diagnosed in patients who perform activities that require repetitive hip flexion and rotational loading. Yoga is an activity growing in popularity that involves these motions. The purpose of this study was to evaluate patients’ ability to return to yoga after hip arthroscopy for FAIS. Hypothesis: There would be a high rate of return to yoga after hip arthroscopy. Study Design: Retrospective analysis. Level of Evidence: Level 4. Methods: Consecutive patients with FAIS who had identified themselves as participating in yoga and had undergone hip arthroscopy for the treatment of FAIS between 2012 and 2015 were reviewed. Demographic data were collected and assessed for all patients, as well as preoperative physical examination, imaging, and patient-reported outcome (PRO) scores, including the modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL) and Sports-Specific (HOS-SS) subscales, and visual analog scale (VAS) for pain. Postoperatively, examination and PRO data were collected at a minimum 1 year after surgery, including a yoga-specific questionnaire. Results: A total of 42 patients (90% female; mean age, 35 ± 9 years; mean body mass index, 23.1 ± 3.2 kg/m2) were included. Thirty patients (71%) had to discontinue their yoga routine preoperatively because of hip-related symptoms at a mean 9.5 ± 8.2 months before surgery. After surgery, 39 patients (93%) were able to return to yoga at a mean 5.3 ± 2.2 months after surgery. Two of the 3 patients who did not return to yoga noted loss of interest as their reason for stopping, while 1 patient was unable to return because of persistent hip pain. Nineteen patients (45%) returned to a higher level of yoga practice, 17 patients (40%) returned to the same level, and 3 patients (7%) returned to a lower level. There was no difference in the number of hours spent practicing yoga per week pre- and postoperatively (2.7 ± 1.9 vs 2.5 ± 1.3 hours; P = 0.44). All patients demonstrated significant improvement in all PROs as well as pain scores after surgery (HOS-ADL, 67.4 ± 18.3 to 93.1 ± 6.9 [ P < 0.001]; HOS-SS, 45.6 ± 24.7 to 81.5 ± 18.8 [ P < 0.001]; mHHS, 62.3 ± 11.3 to 86.8 ± 12.3 [ P < 0.0001]; VAS pain, 6.3 ± 2.2 to 0.90 ± 1.1 [ P < 0.001]). Conclusion: Patients participating in yoga return to yoga 93% of the time and at a mean 5.3 ± 2.2 months after hip arthroscopy for FAIS. Clinical Relevance: Information regarding surgical outcomes is critical in counseling patients, particularly female athletes, on their expectations with respect to returning to yoga after hip arthroscopy for FAIS.

scholarly journals Preoperative Hip Extension Strength Is an Independent Predictor of Achieving Clinically Significant Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome

2020 ◽  
Vol 12 (4) ◽  
pp. 361-372 ◽  
Author(s):  
Edward C. Beck ◽  
Benedict U. Nwachukwu ◽  
Laura M. Krivicich ◽  
Philip Malloy ◽  
Sunikom Suppauksorn ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Case Series ◽  
Impingement Syndrome ◽  
Level Of Evidence ◽  
Hip Strength ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Hip Extension ◽  
Abduction Strength

Background: The effect of preoperative hip strength on outcomes after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) is unclear. The purpose of this study was to determine whether preoperative isometric hip strength is associated with outcome scores at 6 months as well as achieving the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) in patients undergoing hip arthroscopy for FAIS. Hypothesis: Increased preoperative isometric strength will be correlated with short-term postoperative outcomes and will be predictive of achieving higher functional status. Study Design: Case series. Level of Evidence: Level 4. Methods: Data from 92 consecutive patients undergoing primary hip arthroscopy for treatment of FAIS from March through August 2018 were analyzed. All patients included in the analysis had preoperative measures of isometric hip strength on both affected and unaffected limbs, as well as preoperative and 6-month patient-reported outcome (PRO) scores. Analysis was performed to determine correlations between normalized isometric hip strength measurements and PROs and whether strength measurements were predictive of achieving MCID or PASS. Results: A total of 74 (80.4%) patients had 6-month PROs and were included in the final analysis. Hip extension strength on both sides was correlated with all postoperative PROs (all P > 0.05). Abduction strength on both sides was correlated with postoperative Hip Outcome Score–Activities of Daily Living subscale score, achieving MCID on at least 1 score threshold, and reaching the international Hip Outcome Tool-12 threshold score for achieving PASS (all P < 0.05). Regression analysis showed that extension strength on the affected side was the only strength measurement predictor of achieving PASS (1.043; P = 0.049). Conclusion: Preoperative isometric hip extension and abduction strength are correlated with 6-month postoperative PRO scores. Furthermore, hip extension strength is a predictor of achieving clinically meaningful outcomes. Clinical Relevance: This study highlights the possible importance of preoperative optimization of hip function to maximize outcomes in patients undergoing hip arthroscopy for FAIS.

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