Hip arthroscopy outcomes: a longitudinal study

Leeferink, Samantha Jane
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Introduction: Hip arthroscopy is not a new technology and thanks to improvements in surgical equipment and procedures, it is now a relatively well-utilised procedure in the management of hip disorders. Hip arthroscopy is used as a joint preservation measure. Although many hip disorders affect the younger population, these disorders are commonly associated with the older population. Insight into the recovery and return to an active or sporting lifestyle is important after hip arthroscopy. Research into this topic is scarce and there is no evidence of the outcomes after hip arthroscopic surgery in a South African context. Aim of Study: The aim of the study was to establish the change in patient outcomes regarding perceived quality of life, hip functional performance and pain from baseline preoperatively to six months post hip arthroscopic surgery. Study Design: An observational, longitudinal study with a comparative age and gender matched control group was used. Methods: Seventy-two participants were involved in this study. The surgical group (n=36) were consecutively sampled from a population of people undergoing hip arthroscopic surgery at Life Fourways Hospital. The control group (CG) (n=36) were an age and gender matched population who had never experienced hip pain. Ethical approval was sought from and granted by the Human Research Ethics Committee (HREC) of the University of the Witwatersrand. Three patient reported outcomes (PRO’s) and one functional outcome were measured preoperatively (SG1) and six-months postoperatively (SG2). The PRO’s included the International Hip Outcome Tool (iHOT33), Global Perceived Effect scale (GPE) and the Numeric Rating Scale for pain (NRS). The functional outcome was the single leg balance test (SLB). Descriptive and comparative statistics are reported for all outcomes. Stata version 14.2 was used for analysis. Results: Age, height and weight were normally distributed in both groups and were similar on paired t-testing of age (p=0.3242), height (p=0.1047) and weight (p=0.3896). The iHOT33 scores showed a statistically significant improvement from baseline to follow-up iv in the surgical group (p<0.0001). The GPE was rated as a “better” outcome by 28 participants (n=36) at SG2. A statistically significant improvement was noted in the NRS pain scores from baseline to follow up in the surgical group in the left (p=0.0069) and right (p=0.0008) hips. A statistically significant improvement was noted in the SLB tests from baseline to follow-up in the surgical group in the left (p=0.0022) and right (p=0.0004) hip. The surgical group showed significant improvement in all outcomes but was still significantly less than the outcomes of the control group. A moderate to strong negative correlation was found between the iHOT33 scores and pain in SG1 left hip and right hip and SG2 left hip and right hip. Conclusion: There was a significant improvement in all measured outcomes at six months post hip arthroscopy. However, the outcomes had not improved to the level of the control group’s. Future research should investigate the time frame for the surgical group to regain a “normal” function as per the control group and the possibilities of improved physiotherapy rehabilitation to reach optimal function.
A dissertation submitted in fulfilment of the requirements for the degree Master of Science in Physiotherapy to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020