ePoster #707 - ISHA Annual Scientific Meeting 2016

Responsiveness of Faber Distance and Hip Range of Motion Following Arthroscopic Surgery in Patients with Symptomatic Femoroacetabular Impingement

Alexis Wright, PT, PhD, High Point, NC UNITED STATES
Elizabeth A. Howse, MD, Walnut Creek, CA UNITED STATES
Ryan H. Barnes, BS, Richmond, VA UNITED STATES
Thomas J. Kelsey, MA, Winston Salem, NC UNITED STATES
Andre Antunes, HSDG, Winston Salem, NC UNITED STATES
Halis Atil Atilla, MD, Ankara TURKEY
Allston J. Stubbs, MD, MBA, Winston Salem, NC UNITED STATES

Wake Forest Baptist Health, Winston-Salem, NC, UNITED STATES

FDA Status Cleared

Summary: Our data from a 600 subject surgical database demonstrates short term improvement in hip range of motion and FABER distance after hip arthroscopy for femoroacetabular impingement.

Introduction: Femoroacetabular impingement is considered a precursor to chondrolabral disease and secondary hip osteoarthritis. Hip osteoarthritis and its precursors typically impair range of motion, and recovery of motion after open surgical hip dislocation for femoroacetabular impingement may be limited. The purpose of this study is to examine the progression of clinical motion impairments immediately, 1 month, and 4 months post hip arthroscopy for femoroacetabular impingement. Our hypothesis is that range of motion will have a positive short term improvement after arthroscopic surgery for femoroacetabular impingement.

Methods: Hip impairment measures were prospectively administered at four time points (pre-operatively, intra-operatively after surgical treatment, and at 1 month and 4 months post-operatively) to 600 consecutive patients who underwent hip arthroscopy. Descriptive statistics including the mean and 95% confidence interval were calculated for all measures for each of the four time points. Statistical analysis comprised a paired samples t- to characterize the relative change among the measures at each corresponding assessment point. Three change scores were created for each measure, by taking the difference between the preoperative assessment values and the intra-operative, first and second postoperative assessment values. Significance was determined at p<0.05.

Results: Hip flexion, internal rotation, and FABER measurements all improved significantly over the first assessment period (preop to intra-operatively). Mean hip flexion improved significantly from 98.1 (14.4) degrees pre-operatively to 107.1 (8.4) degrees intra-operatively (p<0.001); mean internal rotation improved significantly from 13.4 (12.0) degrees pre-operatively to 23.3 (11.9) degrees post-operatively (p<0.001); mean FABER improved significantly from 24.1 (8.9) cm pre-operatively to 16.7 (7.4) cm post-operatively (p<0.001). No additional changes were found in hip flexion or internal rotation measures at one month post-operatively. The FABER measurement showed significant deterioration from intra-operative to the first post-operative assessment. Mean FABER deteriorated from 16.7 (7.4) cm intra-operatively to 24.8 (8.2) cm at one month post-operatively (p<0.001). All measures again showed significant improvements from 1 month post-operatively to 4 months post-operatively with hip flexion improving significantly from 104.8 degrees (8.0) at 1 month post-op to 110.0 degrees (10.3) at 4 months post-op (p<0.001); hip internal rotation improved from 20.9 (9.2) degrees at 1 month post-op to 22.7 (11.3) degrees at 4 months post-op (p<0.001); and FABER improved significantly from 24.8 (8.2) cm to 16.8 (7.6) cm at four months post-operatively (p<0.001).

Conclusions: Our data from a large surgical database supports our hypothesis of short term improvement in hip range of motion and FABER distance after hip arthroscopy for femoroacetabular impingement. These improvements in hip range of motion and FABER measures were seen in patients both intra-operatively immediately after surgical treatment and four months post-operative arthroscopic surgery.