Rehabilitation Following Hip Arthroscopy – A Qualitative and Quantitative Assessment of the Effect of Physical Therapy Characteristics On Treatment Success - הכנס השנתי ה-38 של האיגוד הישראלי לאורתופדיה בשיתוף עם הכנס השנתי ה-28 של האיגוד הישראלי לכירורגיה של היד

Adrian Tudor ¹ Michal Frankl ³ Shai Factor ¹ Ran Atzmon ⁴ Eyal Amar ¹ Harrison Volaski ² Ehud Rath ¹

¹Othopedic Surgery, Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
²Sackler Faculty of Medicine, Tel-Aviv University, Israel
³Othopedic Surgery, Assaf HaRofe Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
⁴Othopedic Surgery, Assuta University Hospital, Faculty of Health Sciences, Ben Gurion University of the Negev, Israel

Background: Despite the increasing volume of arthroscopic hip preservation surgeries, there remains a paucity of evidence to guide post-operative physical therapy (PT) protocol for hip arthroscopy treating femoracetabular impingement (FAI).

Purpose: To evaluate the effect on mid-term outcomes of various PT parameters following hip arthroscopy treating FAI.

Methods: 133 patients who underwent hip arthroscopy treating FAI and labral repair with 2-year follow-up between January 2011-May 2016, were reviewed. Patients were stratified into age groups (<30, 30-50, >50 y.o.). PT protocols were assessed for: time to first session, training frequency and duration, committed self-practice and physical therapy provider. Patient reported outcome measures (PROMS) included the Modified Harris Hip Score (MHHS) and Hip Outcome Score (HOS). Rates of satisfaction were recorded by asking patients whether, considering the outcome, they would undergo the surgery again.

Results: Statistical analysis for PT variables did not differ significantly for gender (P = 0.288 – 1.000). Improvement did not differ significantly for patients that started rehabilitation later than one week (P = 0.235 – 0.9), practiced more than 3 times a week (P = 0.114 – 1.000), for more than 45 minutes (P = 0.109 – 0.969), for more than 3 months (P = 0.093 – 0.986) or committed to self-practice (P = 0.07 – 0.92). Outcome scores for patients did not differ regarding physical therapy provider (P = 0.077 – 0.991) or satisfaction rates (P = 0.200 – 1.000). Of note, time to first PT correlated closely with PT frequency (P = 0.03).

Conclusion: Physical therapy following hip arthroscopy does not influence mPROMS or satisfaction rates significantly regardless of gender, baseline scores, program intensity, timing of initiation, or total duration. Further research is required to assess physical therapy protocol following hip arthroscopy treating FAI.