Hobson Taylor E, Metz Allan K, Bellendir Trina R, Froerer Devin L, Rosenthal Reece M, Hunter Collin D R, Featherall Joseph, Maak Travis G, Aoki Stephen K
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA.
School of Medicine, University of Utah, Salt Lake City, Utah, USA.
Am J Sports Med. 2024 Jul;52(8):2021-2028. doi: 10.1177/03635465241252981. Epub 2024 Jun 10.
Physical therapy is frequently utilized in the postoperative care of femoroacetabular impingement syndrome (FAIS). There has been limited research into the efficacy of a structured home exercise program (HEP) compared with formal physical therapy (FPT) in this patient population.
PURPOSE/HYPOTHESIS: The purpose was to evaluate the short-term outcomes of patients utilizing FPT versus an HEP after hip arthroscopic surgery for FAIS. It was hypothesized that both groups would show similar improvements regarding outcome scores, which would improve significantly compared with their preoperative scores.
Cohort study; Level of evidence, 2.
Patients undergoing hip arthroscopic surgery for FAIS at a single center between October 2020 and October 2021 were prospectively enrolled. Patients were allowed to self-select FPT or an HEP and were administered a survey preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. The survey included the Single Assessment Numeric Evaluation, visual analog scale for pain, 12-item International Hip Outcome Tool, Patient-Reported Outcomes Measurement Information System Physical Function, and patient satisfaction with physical therapy and overall care. Statistical analysis was conducted between the 2 groups and within groups to compare preoperative and postoperative scores.
The patients' mean age was 32.6 ± 10.4 years, with 47.2% being female and 57.4% choosing the HEP. At 12 months postoperatively, no significant differences were reported between the FPT and HEP groups regarding the Single Assessment Numeric Evaluation score ( = .795), visual analog scale for pain score ( > .05), Patient-Reported Outcomes Measurement Information System Physical Function T-score ( = .699), 12-item International Hip Outcome Tool score ( = .582), and patient satisfaction ( > .05). Outcome scores at 12 months postoperatively were significantly improved from the preoperative scores across all measures in both groups ( < .001).
There were no significant differences regarding patient outcomes between FPT and the HEP at 1-year follow-up after hip arthroscopic surgery for FAIS when patients selected their own treatment, with both groups demonstrating significant improvements in their outcome scores from their preoperative values. These findings suggest that a structured HEP may be a viable alternative to FPT after hip arthroscopic surgery in patients who prefer a self-directed rehabilitation program.
物理治疗常用于股骨髋臼撞击综合征（FAIS）的术后护理。在这一患者群体中，与正规物理治疗（FPT）相比，对结构化家庭锻炼计划（HEP）疗效的研究有限。
目的/假设：目的是评估FAIS患者髋关节镜手术后采用FPT与HEP的短期疗效。假设两组在疗效评分方面会有相似的改善，且与术前评分相比会有显著提高。
队列研究；证据等级，2级。
前瞻性纳入2020年10月至2021年10月在单一中心接受FAIS髋关节镜手术的患者。患者可自行选择FPT或HEP，并在术前、术后1个月、3个月、6个月和12个月接受调查。调查包括单项评估数字评价、疼痛视觉模拟量表、12项国际髋关节结果工具、患者报告结果测量信息系统身体功能以及患者对物理治疗和整体护理的满意度。对两组之间以及组内进行统计分析，以比较术前和术后评分。
患者的平均年龄为32.6±10.4岁，47.2%为女性，57.4%选择HEP。术后12个月，FPT组和HEP组在单项评估数字评价评分（P = 0.795）、疼痛视觉模拟量表评分（P>0.05）、患者报告结果测量信息系统身体功能T评分（P = 0.699）、12项国际髋关节结果工具评分（P = 0.582）和患者满意度（P>0.05）方面均未报告显著差异。两组术后12个月的所有测量指标的疗效评分均较术前评分有显著改善（P<0.001）。
对于FAIS患者髋关节镜手术后1年的随访，当患者自行选择治疗时，FPT和HEP在患者疗效方面无显著差异，两组的疗效评分均较术前值有显著改善。这些发现表明，对于更喜欢自主康复计划的患者，结构化HEP可能是髋关节镜手术后FPT的可行替代方案。
