Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Dr. Dianne Bryant

2nd Supervisor

Dr. Ryan Degem

Co-Supervisor

Abstract

Femoroacetabular impingement syndrome (FAIS) is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. It is defined as a motion-related disorder of the hip with a triad of symptoms, clinical signs, and imaging findings that represents symptomatic premature contact between the proximal femur and the acetabulum. There are two anatomical morphologies that can cause FAIS, cam, and pincer, and is a challenging clinical pathology. Patients typically undergo hip arthroscopy to repair damage to the joint and recess the bone causing the impingement. These procedures can result in positive outcomes for the patient, like reduced pain and symptoms, but research continues to investigate the optimal methods of ensuring a patient can return to their desired level of function and sports performance after surgery.

Postoperative return to sport guidelines and their efficacy are highly variable. Guidelines are typically broken down to four, five, or six phases of rehabilitation, but return to sport criteria are also variable and based on criteria for other lower extremity injuries. Developing safe, effective, and reproducible guidelines for patients with FAIS after surgery is difficult because they lack clinical data and optimal methods for evaluating a return to sport readiness lack consensus.

Practicing physiotherapists and orthopaedic surgeons who work with patients with FAIS appear to rely heavily on their own level of professional experience when making a postoperative return to sport recommendations rather than an established protocol. Their methods and outcomes for evaluating a patient's functional progress at postoperative follow-up periods and return to sport readiness are highly variable depending on a clinician’s type of practice.

Hip arthroscopy is an effective procedure to reduce impingement and improve a patient’s quality of life. A safe, effective, and reproducible postoperative return to sport guideline has not been established. Future studies should assess the if recommended outcomes suitable to evaluate return to sport readiness and determine which prognosis risk factors can predict if a patient with FAIS can safely return to sport after surgery to ensure they can remain physically active throughout their life.

Summary for Lay Audience

Mechanical hip impingement is a common cause of non-arthritic hip pain and reduced physical activity in active young adults. Hip arthroscopy is an effective procedure to reduce impingement and improve a patient’s quality of life. These procedures can result in positive outcomes for the patient, like reduced pain and symptoms, but research continues to investigate the optimal methods of ensuring a patient can return to their desired level of function and sports performance after surgery. Safe, effective, and reproducible postoperative return to sport guidelines needs to be established because practicing physiotherapists and orthopaedic surgeons currently appear to base postoperative return to sport recommendations on their own expert opinion rather than evidence-based practices.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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