Main Article Content
FAI, arthroscopic surgery, rehabilitative treatment, Hip, Hip Arthroscopy
Background and aim of the work
Femural Acetabular impingement syndrome (FAIS) is a patologic condition that can lead to hip pain, functional limitation and stiffness. In the last few decades orthopedics and physiotherapists have improved both surgery and riabilitative treatment leading to a better and better treatment. The target of this paper il to verify the efficiency of an early and multimodal physiotherapic treatment after and arthroscopic surgery of the FAIS
Materials and Methods
We performed arthroscopic treatment and rehabilitation on 19 patients with mean age of 37±8,3 years, 12 males and 7 females. Each patient has been evaluated preoperatively (T0), postoperatively after 6 week (T1) and after 3 months of follow up (T2), the assessment was carried out by: administration of the VAS and WOMAC score for pain and function and joint examination of active hip movement through an inertial sensor system.
VAS score shows a decrease of pain after 6 week (mean decrease was 36%) and after 3 months (mean decrease was 33%).
WOMAC score shows an increase of the funcional performance of the hip after 3 weeks and after 3 months (in both phases the mean score increase of the 44%)
At last, the analysis of the active movement and of the hip joint showed a generalized increase in all movements both 6 weeks and 3 months after surgery, in particular for flexion (with the knee flexed) and internal rotation movements. of the hip.
The results of this study are in line with the current scientific literature and the protocol used represents a valid tool to complete the surgical treatment.
The proposal of an early, intensive treatment combined with hydrokinesitherapy seems to be safe and effective, however further studies are needed (increasing the sample size) to investigate the results.
2. Myers, S.R., H. Eijer, and R. Ganz, Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res, 1999(363): p. 93-9.
3. Ganz, R., et al., Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res, 2003(417): p. 112-20.
4. Tibor, L.M. and M. Leunig, The pathoanatomy and arthroscopic management of femoroacetabular impingement. Bone Joint Res, 2012. 1(10): p. 245-57.
5. Sankar, W.N., T.H. Matheney, and I. Zaltz, Femoroacetabular impingement: current concepts and controversies. Orthop Clin North Am, 2013. 44(4): p. 575-89.
6. Pun, S., D. Kumar, and N.E. Lane, Femoroacetabular impingement. Arthritis Rheumatol, 2015. 67(1): p. 17-27.
7. Amanatullah, D.F., et al., Femoroacetabular impingement: current concepts in diagnosis and treatment. Orthopedics, 2015. 38(3): p. 185-99.
8. Imam, S. and V. Khanduja, Current concepts in the diagnosis and management of femoroacetabular impingement. Int Orthop, 2011. 35(10): p. 1427-35.
9. Sangal, R.B., G.R. Waryasz, and J.R. Schiller, Femoroacetabular impingement: a review of current concepts. R I Med J (2013), 2014. 97(11): p. 33-8.
10. Enseki, K., et al., Nonarthritic hip joint pain. J Orthop Sports Phys Ther, 2014. 44(6): p. A1-32.
11. Thomas, G.E., et al., Diagnosis and management of femoroacetabular impingement. Br J Gen Pract, 2013. 63(612): p. e513-5.
12. Reiman, M.P., et al., Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear: a systematic review with meta-analysis. Br J Sports Med, 2015. 49(12): p. 811.
13. Di Benedetto, P., et al., Capsular closure after hip arthroscopy: our experience. Acta Biomed, 2020. 91(4-S): p. 92-97.
14. Di Benedetto, P., et al., Capsular management in the arthroscopic treatment of the femoro-acetabular impingement in athletes: our experience. Acta Biomed, 2020. 91(14-S): p. e2020023.
15. Palmer, A.J., et al., Protocol for the Femoroacetabular Impingement Trial (FAIT): a multi-centre randomised controlled trial comparing surgical and non-surgical management of femoroacetabular impingement. Bone Joint Res, 2014. 3(11): p. 321-7.
16. Harris, J.D., et al., Treatment of femoroacetabular impingement: a systematic review. Curr Rev Musculoskelet Med, 2013. 6(3): p. 207-18.
17. Bennell, K.L., et al., Efficacy of a physiotherapy rehabilitation program for individuals undergoing arthroscopic management of femoroacetabular impingement - the FAIR trial: a randomised controlled trial protocol. BMC Musculoskelet Disord, 2014. 15: p. 58.
18. Edelstein, J., et al., Post-operative guidelines following hip arthroscopy. Curr Rev Musculoskelet Med, 2012. 5(1): p. 15-23.
19. Grzybowski, J.S., et al., Rehabilitation Following Hip Arthroscopy - A Systematic Review. Front Surg, 2015. 2: p. 21.
20. Kemp, J.L., et al., A phase II trial for the efficacy of physiotherapy intervention for early-onset hip osteoarthritis: study protocol for a randomised controlled trial. Trials, 2015. 16: p. 26.
21. Malloy, P., M. Malloy, and P. Draovitch, Guidelines and pitfalls for the rehabilitation following hip arthroscopy. Curr Rev Musculoskelet Med, 2013. 6(3): p. 235-41.
22. Spencer-Gardner, L., et al., A comprehensive five-phase rehabilitation programme after hip arthroscopy for femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc, 2014. 22(4): p. 848-59.
23. Wahoff, M., et al., Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase. Int J Sports Phys Ther, 2014. 9(6): p. 813-26.
24. Griffin, D.R., et al., The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med, 2016. 50(19): p. 1169-76.
25. Tijssen, M., et al., A clinical observational study on patient-reported outcomes, hip functional performance and return to sports activities in hip arthroscopy patients. Phys Ther Sport, 2016. 20: p. 45-55.
26. Polat, G., et al., Arthroscopic treatment of femoroacetabular impingement: early outcomes. Acta Orthop Traumatol Turc, 2013. 47(5): p. 311-7.
27. Diamond, L.E., et al., Physical impairments and activity limitations in people with femoroacetabular impingement: a systematic review. Br J Sports Med, 2015. 49(4): p. 230-42.