Dr. Ryan Degen
MD, MSc, FRCSC
Hip arthroscopy, a surgical procedure where a small camera and instruments are inserted into the hip through small cuts, has been increasingly performed in recent years. It is most commonly used to treat a conditional called femoroacetabular impingement (FAI), resulting from extra bone around the hip which changes the conventional shape of the ‘ball-and-socket’ joint. This extra bone causes the ball and socket to hit, or impinge, during specific movements and damage the cartilage, specifically the labrum. The goal of the procedure is to repair damaged cartilage and remove bone causing impingement.
While this surgery is highly effective for relieving pain, the results for returning patients to their desired sport or activity level are less clear.
This likely relates to the variability in various rehabilitation protocols following arthroscopic surgery for FAl, and their recommended timing for return-to-sport (RTS). In order to provide the best chance for a successful outcome and return to sport, better rehabilitation programs and methods for objective evaluation are required. However, consensus is currently lacking on the how to best evaluate RTS readiness because the exact criteria has not been clearly defined. Instead, the decision to return athletes to sport is often based mainly on experience and subjective evaluation, rather than specific criteria or testing results. If clinicians could identify variables or thresholds of certain clinical tests that predict successful RTS, they can potentially use these to better identify when patients can return to sport and achieve their desired outcome more predicably.
We are conducting a multicenter research trial to observe patients’ postoperative functional recovery patterns in hopes of identifying these variables in order to develop a clinical predictive RTS guideline or testing regimen. We are gathering baseline and postoperative data from patients between 16 and 35 years of age to determine their functional recovery patterns following hip surgery for FAl, so that we can determine the prognostic factors most predictive of successful RTS. We are collecting data from patient questionnaires, clinical ex-ams, and functional testing such as balance, hop, and squat testing.
Our hope is that we can develop a clinical prediction tool for this cohort. This predictive model could then help clinicians determine when a patient will be able to successfully RTS or, contrastingly, if they aren’t ready or are unlikely to successfully return to sport. Additionally, the information provided by this tool may help physiotherapists to properly tailor or modify a patient’s postoperative rehabilitation program to meet patient needs where they may be struggling. This study will also help to determine the probability of this cohort being cleared to RTS by their surgeon, returning to the same level of sport, and when these patients have fully returned to sport.