ePoster #1402 - ISHA Annual Scientific Meeting 2016
Hip Functional Impairments Exist Bilaterally, Are Related To Hip Strength And Predict Patient-Reported Outcomes In Patients With Chondrolabral Pathology.
Joanne L. Kemp, PT, PhD, Ballarat, VIC AUSTRALIA
May Arna Risberg, PT, PhD, Oslo NORWAY
Anthony G. Schache, PhD, B.Physio, Melbourne, VIC AUSTRALIA
Michael Makdissi, PhD, MBBS, Melbourne, VIC AUSTRALIA
Michael G. Pritchard, FRACS, Hobart, Tasmania AUSTRALIA
Kay M. Crossley, PhD, B.Physio, Brisbane, QLD AUSTRALIA
University of Queensland, Brisbane, QLD, AUSTRALIA
FDA Status Not Applicable
Summary: Patients with hip chondrolabral pathology have bilateral impairments on functional performance tests 12-24 months after unilateral hip arthroscopy compared to controls. Rehabilitation programs should include hip strength exercises and functional performance retraining in order to optimise outcomes.
Question: In people with chondrolabral pathology 1-2 years post hip arthroscopy: (i) what are between-limb differences in functional performance tests compared to age matched healthy controls; (ii) what is the relationship between functional performance and hip strength and (iii) are measures of functional performance associated with patient-reported outcomes.
Design: Cross-sectional study
Participants: Seventy-one patients with hip chondrolabral pathology (40 (56%) women; age=39±11; height=1.74±0.09m; weight=78±13kg; BMI=27±6kg/m2) 1-2 years post-unilateral hip arthroscopy. Sixty age-matched controls (41 (68%) women; age=36±10; height=1.71±0.09m; weight=70±12kg; BMI=23±3kg/m2) with no history of hip surgery or pain in the past 6 months.
Outcome measures: Patients’ characteristics, the International Hip Outcome Tool (iHOT-33) patient-reported outcome measure (PRO), functional performance and hip muscle strength were collected. Functional performance tests included the single leg hop (hop) test, the side bridge (bridge) test and the one leg rise (rise) test.
Results: The chondrolabral group had significantly poorer performance compared to controls on (i) number of rises for both the surgical (MD (95%CI) 14 (8 to 19); and the non-surgical side (14 (8 to 19) rises); (ii)the hop for both the surgical (32 (21 to 42)cm); and the non-surgical side(37(27 to 47)cm); (iii)the bridge on the surgical (23(10 to 36) seconds) and the non-surgical side (24(11 to 37) seconds). Greater hip abduction (adjusted r2 0.310 p<0.001); adduction (adjusted r2 0.547 p<0.001); and extensor strength (adjusted r2 ranges 0.407 to 0.613 p<0.001) was associated with better functional performance. In addition, better performance on the bridge test and hop test (adjusted r2 ranges 0.285 to 0.481 p<0.001), was associated with better PRO scores.
Conclusion: Patients with hip chondrolabral pathology have bilateral impairments on functional performance tests 12-24 months after unilateral hip arthroscopy compared to controls. Rehabilitation programs should include hip strength exercises and functional performance retraining in order to optimise outcomes.
Key Practice Points:
• Hip arthroscopy is commonly performed on patients with chondrolabral pathology. However, it is unknown whether patients have residual functional deficits post-surgery, or whether such impairments are related to co-existing strength deficits or patient reported outcomes.
• In patients with chondrolabral pathology, greater strength in hip abduction, adduction and extension were associated with better functional performance, while better performance in the bridge and hop tests were associated with better PROs.
• These findings may guide clinicians in designing targeted rehabilitation programs that optimise PROs for these patients.