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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2020

Open Access 01-04-2020 | HIP

Full recovery of hip muscle strength is not achieved at return to sports in patients with femoroacetabular impingement surgery

Authors: Sam Hallberg, Mikael Sansone, Jesper Augustsson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2020

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Abstract

Purpose

The purpose of this study was to study dynamic hip  external rotation strength in patients with Femoroacetabular impingement surgery (FAI) syndrome who have undergone unilateral arthroscopic treatment and returned to sports.

Methods

A cross-sectional study was performed using an observational group (n = 22) and a matched control group (n = 22). Dynamic external rotation strength of the hip was measured using the Augustsson Strength Test, which has shown high reliability for examining side-to-side differences in hip muscle strength.

Results

Dynamic hip external rotation strength was significantly lower in the arthroscopically treated hip compared with the non-treated hip within the observational group (p < 0.004).

Conclusion

This cross-sectional study shows that at return to sports, patients who have undergone unilateral arthroscopic treatment for FAI syndrome do not have adequate hip muscle strength recovery. Rehabilitation protocols should, therefore, emphasise post-operative strength training of the hip muscles. Additional research is needed to determine the consequences of reduced hip strength for the long-term outcome after arthroscopically treated FAI. Clinical relevance: The results of this study underline the importance of post-operative strength training prior to returning to sports in patients with femoroacetabular impingement surgery.

Level of evidence

III.
Literature
1.
Almeida GPL, das Neves Rodrigues HL, de Freitas BW, de Paula Lima PO (2017) Reliability and validity of the hip stability isometric test (HipSIT): a new method to assess hip posterolateral muscle strength. J Orthop Sports Phys Ther 47:906–913CrossRef
2.
Augustsson J (2016) A new clinical muscle function test for assessment of hip external rotation strength: Augustsson strength test. Int J Sports Phys Ther 11:520–526PubMedPubMedCentral
3.
Beaule PE, Speirs AD, Anwander H, Melkus G, Rakhra K, Frei H et al (2017) Surgical correction of cam deformity in association with femoroacetabular impingement and its impact on the degenerative process within the hip joint. J Bone Joint Surg Am 99:1373–1381CrossRef
4.
Bennell KL, Spiers L, Takla A, O’Donnell J, Kasza J, Hunter DJ et al (2017) Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR). BMJ Open 7:e014658CrossRef
5.
Burnham JM, Yonz MC, Robertson KE, McKinley R, Wilson BR, Johnson DL et al (2016) Relationship of hip and trunk muscle function with single leg step-down performance: implications for return to play screening and rehabilitation. Phys Ther Sport 22:66–73CrossRef
6.
Byrd JW (2014) Femoroacetabular impingement in athletes: current concepts. Am J Sports Med 42:737–751CrossRef
7.
Casartelli NC, Leunig M, Maffiuletti NA, Bizzini M (2015) Return to sport after hip surgery for femoroacetabular impingement: a systematic review. Br J Sports Med 49:819–824CrossRef
8.
Casartelli NC, Maffiuletti NA, Item-Glatthorn JF, Staehli S, Bizzini M, Impellizzeri FM et al (2011) Hip muscle weakness in patients with symptomatic femoroacetabular impingement. Osteoarthr Cartil 19:816–821CrossRef
9.
Cheatham SW, Enseki KR, Kolber MJ (2015) Postoperative rehabilitation after hip arthroscopy: a search for the evidence. J Sport Rehabil 24:413–418CrossRef
10.
Contreras B, Vigotsky AD, Schoenfeld BJ, Beardsley C, Cronin J (2015) A comparison of gluteus maximus, biceps femoris, and vastus lateralis electromyographic activity in the back squat and barbell hip thrust exercises. J Appl Biomech 31:452–458CrossRef
11.
Domb BG, Sgroi TA, VanDevender JC (2016) Physical therapy protocol after hip arthroscopy: clinical guidelines supported by 2-year outcomes. Sports Health 8:347–354CrossRef
12.
Enseki K, Harris-Hayes M, White DM, Cibulka MT, Woehrle J, Fagerson TL et al (2014) Nonarthritic hip joint pain. J Orthop Sports Phys Ther 44:A1–A32CrossRef
13.
Grant LF, Cooper DJ, Conroy JL (2017) The HAPI ‘Hip Arthroscopy Pre-habilitation Intervention’ study: does pre-habilitation affect outcomes in patients undergoing hip arthroscopy for femoro-acetabular impingement? J Hip Preserv Surg 4:85–92PubMedPubMedCentral
14.
Heerey J, Risberg MA, Magnus J, Moksnes H, Odegaard T, Crossley K et al (2018) Impairment-based rehabilitation following hip arthroscopy: postoperative protocol for the HIP ARThroscopy International Randomized Controlled Trial. J Orthop Sports Phys Ther 48:336–342CrossRef
15.
Khayambashi K, Ghoddosi N, Straub RK, Powers CM (2016) Hip muscle strength predicts noncontact anterior cruciate ligament injury in male and female athletes: a prospective study. Am J Sports Med 44:355–361CrossRef
16.
17.
King MG, Lawrenson PR, Semciw AI, Middleton KJ, Crossley KM (2018) Lower limb biomechanics in femoroacetabular impingement syndrome: a systematic review and meta-analysis. Br J Sports Med 52:566–580CrossRef
18.
Kuhns BD, Weber AE, Batko B, Nho SJ, Stegemann C (2017) A four-phase physical therapy regimen for returning athletes to sport following hip arthroscopy for femoroacetabular impingement with routine capsular closure. Int J Sports Phys Ther 12:683–696PubMedPubMedCentral
19.
Lewis CL, Loverro KL, Khuu A (2018) Kinematic differences during single-leg step-down between individuals with femoroacetabular impingement syndrome and individuals without hip pain. J Orthop Sports Phys Ther 48:270–279CrossRef
20.
Macadam P, Cronin J, Contreras B (2015) An examination of the gluteal muscle activity associated with dynamic hip abduction and hip external rotation exercise: a systematic review. Int J Sports Phys Ther 10:573–591PubMedPubMedCentral
21.
Malloy PJ, Morgan AM, Meinerz CM, Geiser CF, Kipp K (2016) Hip external rotator strength is associated with better dynamic control of the lower extremity during landing tasks. J Strength Cond Res 30:282–291CrossRef
22.
23.
Mascarenhas VV, Rego P, Dantas P, Morais F, McWilliams J, Collado D et al (2016) Imaging prevalence of femoroacetabular impingement in symptomatic patients, athletes, and asymptomatic individuals: a systematic review. Eur J Radiol 85:73–95CrossRef
24.
Mayne E, Memarzadeh A, Raut P, Arora A, Khanduja V (2017) Measuring hip muscle strength in patients with femoroacetabular impingement and other hip pathologies: a systematic review. Bone Joint Res 6:66–72CrossRef
25.
Menge TJ, Briggs KK, Dornan GJ, McNamara SC, Philippon MJ (2017) Survivorship and outcomes 10 years following hip arthroscopy for femoroacetabular impingement: labral debridement compared with labral repair. J Bone Joint Surg Am 99:997–1004CrossRef
26.
Mucha MD, Caldwell W, Schlueter EL, Walters C, Hassen A (2017) Hip abductor strength and lower extremity running related injury in distance runners: a systematic review. J Sci Med Sport 20:349–355CrossRef
27.
Naal FD, Miozzari HH, Kelly BT, Magennis EM, Leunig M, Noetzli HP (2013) The Hip Sports Activity Scale (HSAS) for patients with femoroacetabular impingement. Hip Int 23:204–211CrossRef
28.
Nepple JJ, Goljan P, Briggs KK, Garvey SE, Ryan M, Philippon MJ (2015) Hip strength deficits in patients with symptomatic femoroacetabular impingement and labral tears. Arthroscopy 31:2106–2111CrossRef
29.
Ng VY, Arora N, Best TM, Pan X, Ellis TJ (2010) Efficacy of surgery for femoroacetabular impingement: a systematic review. Am J Sports Med 38:2337–2345CrossRef
30.
31.
Sansone M (2016) Outcomes of arthroscopic hip surgery in patients with femoro-acetabular impingement. Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Göteborg. ISBN: 978-91-628-9704-8S
32.
Sansone M, Ahlden M, Jonasson P, Thomee C, Sward L, Baranto A et al (2015) Good results after hip arthroscopy for femoroacetabular impingement in top-level athletes. Orthop J Sports Med 3:2325–9671CrossRef
33.
Selkowitz DM, Beneck GJ, Powers CM (2013) Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes. J Orthop Sports Phys Ther 43:54–64CrossRef
34.
Thomee R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D et al (2011) Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1798–1805CrossRef
35.
Thorborg K, Serner A, Petersen J, Madsen TM, Magnusson P, Holmich P (2011) Hip adduction and abduction strength profiles in elite soccer players: implications for clinical evaluation of hip adductor muscle recovery after injury. Am J Sports Med 39:121–126CrossRef
36.
Zadpoor AA (2015) Etiology of femoroacetabular impingement in athletes: a review of recent findings. Sports Med 45:1097–1106CrossRef
37.
Zhang ZJ, Lee WC, Ng GYF, Fu SN (2018) Isometric strength of the hip abductors and external rotators in athletes with and without patellar tendinopathy. Eur J Appl Physiol 118:1635–1640CrossRef
Metadata
Title
Full recovery of hip muscle strength is not achieved at return to sports in patients with femoroacetabular impingement surgery
Authors
Sam Hallberg
Mikael Sansone
Jesper Augustsson
Publication date
01-04-2020
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-5337-0

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