Amar Eyal, Martin RobRoy L, Tudor Adrian, Factor Shai, Atzmon Ran, Rath Ehud
Division of Orthopedic Surgery, Tel Aviv Medical Center Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Physical Therapy, Rangos School of Health Sciences, Duquesne University, Pittsburgh, Pennsylvania, USA.
Orthop J Sports Med. 2021 Jan 28;9(1):2325967120981888. doi: 10.1177/2325967120981888. eCollection 2021 Jan.
Arthroscopic hip-preservation surgery is commonly performed to address nonarthritic sources of hip pain in young, active individuals. However, there is little evidence to support postoperative rehabilitation protocols, including the most appropriate frequency and length of individual formal physical therapy sessions. There is also a lack of information to look at patients' perceived value of their home program/self-practice in relation to outcomes.
To investigate postoperative rehabilitation factors after hip arthroscopy related to formal physical therapy and home program/self-practice and their correlation with patient outcomes and satisfaction.
Cohort study; Level of evidence, 3.
A total of 125 patients who underwent hip arthroscopy for femoroacetabular impingement syndrome and a labral tear (75 men) were included. The mean age was 34.6 ± 14.4 years, and the mean follow-up time was 4.9 ± 1.6 years. Hip Outcome Score-Activities of Daily Living subscale (HOS-ADL) scores, overall satisfaction scores, and factors related to supervised physical therapy and home program/self-practice were collected. Correlations between continuous variables and differences in the length of individual formal physical therapy and patients' rating of the importance of their home program/self-practice between those who would and those who would not undergo surgery again were assessed.
The frequency and length of individual formal physical therapy sessions were significantly correlated with postoperative HOS-ADL scores ( = 0.22, = .014; and = 0.24, = .007, respectively) and level of satisfaction ( = 0.24, = .007; and = 0.21, = .02, respectively). The length of individual formal physical therapy sessions was significantly greater in those who noted they would undergo surgery again (35.3 vs 26.3; = .033). A significant correlation was identified between the rating of the importance of their home program/self-practice and postoperative HOS-ADL scores ( = 0.29; = .001) and their level of satisfaction ( = 0.23; = .009). There was a significant difference in the rating of the importance of their home program/self-practice between those who would undergo surgery again and those who would not (8.9 vs 7.8; = .007).
Surgeons and physical therapists should emphasize the value of home program/self-practice when it comes to outcomes and may want to encourage their patients to participate in more frequent, longer, formal physical therapy sessions.
关节镜下髋关节保留手术常用于治疗年轻、活跃个体非关节炎性髋关节疼痛的病因。然而，几乎没有证据支持术后康复方案，包括个体正式物理治疗疗程的最合适频率和时长。关于患者对家庭康复计划/自我练习与治疗结果相关的感知价值方面的信息也很匮乏。
研究髋关节镜检查术后与正式物理治疗以及家庭康复计划/自我练习相关的康复因素，及其与患者治疗结果和满意度的相关性。
队列研究；证据等级为3级。
纳入125例行髋关节镜检查治疗股骨髋臼撞击综合征和盂唇撕裂的患者（75例男性）。平均年龄为34.6±14.4岁，平均随访时间为4.9±1.6年。收集髋关节功能评分-日常生活活动量表（HOS-ADL）评分、总体满意度评分，以及与监督下的物理治疗和家庭康复计划/自我练习相关的因素。评估连续变量之间的相关性，以及个体正式物理治疗疗程时长的差异，和愿意再次接受手术与不愿意再次接受手术的患者对家庭康复计划/自我练习重要性的评分差异。
个体正式物理治疗疗程的频率和时长与术后HOS-ADL评分（分别为r = 0.22，P = 0.014；和r = 0.24，P = 0.007）以及满意度水平（分别为r = 0.24，P = 0.007；和r = 0.21，P = 0.02）显著相关。表示愿意再次接受手术的患者个体正式物理治疗疗程的时长显著更长（35.3对26.3；P = 0.033）。患者对家庭康复计划/自我练习重要性的评分与术后HOS-ADL评分（r = 0.29；P = 0.001）及其满意度水平（r = 0.23；P = 0.009）之间存在显著相关性。愿意再次接受手术与不愿意再次接受手术的患者对家庭康复计划/自我练习重要性的评分存在显著差异（8.9对7.8；P = 0.007）。
外科医生和物理治疗师在治疗结果方面应强调家庭康复计划/自我练习的价值，可能还应鼓励患者参加更频繁、更长时间的正式物理治疗疗程。
