Müller-Torrente Alexis, Puig-Torregrosa Jordi, Montero-Navarro Sergio, Sanz-Reig Javier, Morera-Balaguer Jaume, Más-Martínez Jesús, Sánchez-Mas Jesús, Botella-Rico Jose M
Department of Physiotherapy, Alicante Clinic, 03010 Alicante, Spain.
Department of Traumatology, Traumadvance Clinic, 08222 Terrassa, Spain.
J Clin Med. 2021 Jul 15;10(14):3125. doi: 10.3390/jcm10143125.
(1) To assess the efficacy of a specific rehabilitation protocol for femoroacetabular impingement syndrome (FAIS), patients who underwent hip arthroscopy (HA) were compared with a control group. (2) Patients with symptomatic FAIS who were scheduled for HA were randomized either to a control group ( = 45, 66.6% men, 41.8 ± 12.4 years) following a general post-surgical treatment protocol or to an experimental group ( = 45, 71.2% men, 40.9 ± 7.6 years) following a specific rehabilitation protocol supervised by a physiotherapist. Range of motion (ROM), orthopedic tests and pain were assessed immediately before surgery and at 4 and 14 weeks after surgery. The hip functional status was assessed by the modified Harris Hip Score (mHHS) before surgery and at the end of follow-up. (3) At 14 weeks after surgery and compared with the control group, the experimental group showed a lower percentage of positives for hip provocation tests (15.6% vs. 46.6% on Faber test; 15.6% vs. 77.8% on Fadir test; 2.2% vs. 20% on Ober test, experimental vs. control group, < 0.001), a greater improvement in mHHS (27.2 vs. 10.7 points, < 0.001) and higher ROM for all the movements evaluated: flexion (99.6 ± 12.2 vs. 89.6 ± 4.5, < 0.001), extension (20.6 ± 5.8 vs. 13.3 ± 2.6, < 0.001), adduction (30.6 ± 5.7 vs. 23.4 ± 8.4, < 0.001), abduction (43.4 ± 10.7 vs. 32.8 ± 8.4, < 0.001) and both internal (28.2 ± 8.5 vs. 18.7 ± 6.1, < 0.001) and external hip rotation (36.8 ± 9.3 vs. 27.4 ± 5.6. < 0.001). The pain decreased after surgery for both groups, although the reduction was greater in the experimental group at the end of intervention (13.8 ± 16.1 vs. 34.9 ± 16.3 mm, experimental vs. control group, < 0.001). (4) The specific and supervised rehabilitation program in patients with FAIS undergoing HA showed better benefits at 14 weeks of treatment than the benefits achieved by a care protocol in terms of pain reduction and recovery of hip motion.
(1) 为评估一种针对股骨髋臼撞击综合征(FAIS)的特定康复方案的疗效,将接受髋关节镜检查(HA)的患者与对照组进行比较。(2) 计划接受HA的有症状FAIS患者被随机分为两组,一组为对照组(n = 45,男性占66.6%,年龄41.8±12.4岁),遵循一般的术后治疗方案;另一组为实验组(n = 45,男性占71.2%,年龄40.9±7.6岁),遵循由物理治疗师监督的特定康复方案。在手术前、术后4周和14周时评估活动范围(ROM)、骨科检查和疼痛情况。在手术前和随访结束时通过改良Harris髋关节评分(mHHS)评估髋关节功能状态。(3) 术后14周时,与对照组相比,实验组髋关节激发试验阳性率更低(Faber试验:15.6%对46.6%;Fadir试验:15.6%对77.8%;Ober试验:2.2%对20%,实验组对对照组,P < 0.001),mHHS改善更大(27.2分对10.7分,P < 0.001),并且在所有评估的运动中ROM更高:屈曲(99.6±12.2对89.6±4.5,P < 0.001)、伸展(20.6±5.8对13.3±2.6,P < 0.001)、内收(30.6±5.7对23.4±8.4,P < 0.001)、外展(43.4±10.7对32.8±8.4,P < 0.001)以及髋关节内旋(28.2±8.5对18.7±6.1,P < 0.001)和外旋(36.8±9.3对27.4±5.6,P < 0.001)。两组术后疼痛均减轻,尽管在干预结束时实验组疼痛减轻幅度更大(13.8±16.1对34.9±16.3mm,实验组对对照组,P < 0.001)。(4) 对于接受HA的FAIS患者,特定的、有监督的康复方案在治疗14周时,在减轻疼痛和恢复髋关节活动方面比常规护理方案显示出更好的效果。