ABSTRACT
AIMS: To compare (a) the change in radiological bony morphology between participants with femoroacetabular impingement (FAI) syndrome who underwent arthroscopic hip surgery compared to physiotherapist-led non-surgical care and (b) the change in radiological bony morphology between participants with FAI syndrome who underwent arthroscopic hip surgery involving cam resection or acetabular rim trimming or combined cam resection and acetabular rim trimming. METHODS: Maximum alpha angle measurements on magnetic resonance imaging and Hip2 Norm standardized hip measurements on radiographs were recorded at baseline and at 12 months postoperatively. One-way analysis of covariance and independent T tests were conducted between participants who underwent arthroscopic hip surgery and physiotherapist-led non-surgical care. Independent T tests and analysis of variance were conducted between participants who underwent the 3 different arthroscopic hip procedures. RESULTS: Arthroscopic hip surgery resulted in significant improvements to mean alpha angle measurements (decreased from 70.8° to 62.1°) (P value < .001, 95% CI -11.776, -4.772), lateral center edge angle (LCEA) (P value = .030, 95% CI -3.403, -0.180) and extrusion index (P value = 0.002, 95% CI 0.882, 3.968) compared to physiotherapist-led management. Mean maximum 1-year postoperative alpha angle was 59.0° (P value = .003, 95% CI 4.845, 18.768) for participants who underwent isolated cam resection. Measurements comparing the 3 different arthroscopic hip procedures only differed in total femoral head coverage (F[2,37] = 3.470, P = .042). CONCLUSION: Arthroscopic hip surgery resulted in statistically significant improvements to LCEA, extrusion index and alpha angle as compared to physiotherapist-led management. Measured outcomes between participants who underwent cam resection and/or acetabular rim trimming only differed in total femoral head coverage.
Subject(s)
Femoracetabular Impingement , Humans , Femoracetabular Impingement/diagnostic imaging , Femoracetabular Impingement/surgery , Arthroscopy , Treatment Outcome , Magnetic Resonance Imaging , Radiography , Hip Joint/diagnostic imaging , Hip Joint/surgery , Retrospective StudiesABSTRACT
Objectives: The primary objective was to examine baseline patient activation as a prognostic factor for changes in pain and function following participation in an osteoarthritis management program. The secondary objective was to examine other prognostic factors from existing literature (e.g. employment, functional performance, depression, comorbidities). Method: One-hundred-and-eleven participants with knee osteoarthritis were assessed at 0-, 12- and 26-weeks in this prospective clinical cohort. Demographic variables, timed-up-and-go (TUG), patient activation measure (PAM-13), Depression Anxiety Stress Scale and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were collected. Multivariable linear regression examined relationships between prognostic factors and pain and function at 12- and 26-weeks. Results: Complete 12- and 26-week data were available for 89 and 74 participants respectively, 66 â% female, 66.8 (SD 10.0) years, 74 â% unemployed, 66 â% finished high school or higher, 12 â% on joint arthroplasty waitlists. Baseline PAM-13 scores were not associated with changes in pain or function at 12- or 26-weeks. Employment status (ß â= â9.17 (95 â% CI 2.11, 16.24), p â= â0.01) and TUG (ß â= â-1.20 (95 â% CI -1.91, -0.49), p â< â0.01) were associated with changes in pain at week-12. Employment status (ß â= â11.60 (95 â% CI 5.31, 17.90), p â< â0.01) and TUG (ß â= â-1.10 (95%CI -1.78, -0.43), p â< â0.01) were associated with 12-week function. Baseline TUG (ß â= â-1.32 (95 â% CI -2.40, -0.23), p â= â0.02) was associated with week-26 WOMAC function. Conclusions: Baseline PAM-13 scores were not associated with changes in pain and function at any timepoint. Employment status and TUG were associated with changes in pain and function at 12-weeks, TUG was associated with 26-week function.
