Early recovery after hip arthroscopy for femoroacetabular impingement syndrome: a prospective, observational study.

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2017-12

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Abstract

The early post-operative course after hip arthroscopy for femoroacetabular impingement syndrome has not been thoroughly characterized or correlated to factors that may influence recovery. The aim of this study was to report on early pain, function and attitudes towards rehabilitation and to determine predictors of early recovery after hip arthroscopy. Sixty-two patients reported pre-operative pain, iHOT-12 (hip functional score), psychological status and other baseline characteristics. Pain, iHOT-12, hip flexion and several other outcomes were measured through 6 weeks post-operative. Baseline characteristics were correlated with outcomes using univariate and multivariable models. Pain relief started on post-operative day 1 and consistently improved throughout the 6 weeks of follow-up. The average patient's pain was reduced from a pre-operative level of 5/10 to 2/10 by 6 weeks post-operative. Similarly, iHOT-12 improved from 33/100 to 57/100 whereas hip flexion increased by 9° by 6 weeks post-operative. At 2 weeks post-operative, pre-operative anti-inflammatory usage was associated with greater improvement in pain and swelling; pre-operative opioid usage with poorer patient-reported helpfulness of and adherence to rehabilitation; and higher ASA (American Society of Anesthesiologists) score and lower procedure time with improvement of the pre-operative pain complaint. At 6 weeks, greater depression was associated with lower post-operative pain reduction but greater pre-operative pain complaint improvement. Continuous passive motion usage was associated with increased hip flexion. Pain improved from pre-operative by Day 1 after hip arthroscopy, and early functional improvements were seen by 6 weeks post-operative. Pre-operative anti-inflammatory and opioid usage, depression, race, ASA score, procedure time and continuous passive motion usage were significantly associated with study outcomes.

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10.1093/jhps/hnx026

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Cunningham, DJ, BD Lewis, CA Hutyra, RC Mather and SA Olson (2017). Early recovery after hip arthroscopy for femoroacetabular impingement syndrome: a prospective, observational study. Journal of hip preservation surgery, 4(4). 10.1093/jhps/hnx026 Retrieved from https://hdl.handle.net/10161/16764.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Lewis

Brian David Lewis

Associate Professor of Orthopaedic Surgery

I am an assistant professor in the department of orthopaedics.  My sub-specialty interest is in hip surgery including arthroplasty and non-arthoplasty hip surgery.  This includes the treatment of osteoarthritis, hip dysplasia, hip impingement, labral tears, as well as various tendon disorders around the hip.

The research interests include outcomes research for hip surgeries, hip movement disorders related to hip conditions, and factors influencing opioid use in post-surgical patients.

Mather

Richard Charles Mather

Clinical Associate in the Department of Orthopaedic Surgery

Richard C. “Chad” Mather III MD, MBA is an assistant professor and vice chairman of practice innovation in the Department of Orthopaedic Surgery at Duke University School of Medicine.  He is also a faculty member at the Duke Clinical Research Institute.  Dr. Mather is a health services researcher and decision scientist with a focus on economic analysis, health policy, health preference measurement and personalized decision-making.  His current work focuses on building tools for healthcare consumerism by facilitating measurement and communication of individual patient preferences in treatment decisions.  Additionally, he has great interest in health innovation, particularly in developing new care and payment models to foster different incentives and practice approaches.  He was a health policy fellow with the American Academy of Orthopaedic Surgeons and the Arthroscopy Association of North America. Dr. Mather received an undergraduate degree in economics from Miami University and a medical doctorate and masters in business administration from Duke, where he also completed residency training in orthopaedic surgery. He completed a sports medicine fellowship at Rush University Medical Center.  His clinical practice focuses on hip arthroscopy including both FAI and extra-articular hip endoscopy.  Specifically to the hip in addition to health service research applications he conducts translational research on biomarkers and hip instability. 

Olson

Steven Arthur Olson

Goldner Jones Distinguished Professor of Orthopaedic Surgery

As an Orthopedic Surgeon my primary focus of research is joint preservation. My primary clinical interests are Orthopedic Trauma and Hip Reconstruction.

In Orthopedic Trauma my research interests are 1) Basic science investigations of articular fractures with two current animal models in use. 2) Clinical research includes evaluation of techniques to reduce and stabilize articular fractures, as well as management of open fractures.

In the area of Hip Reconstruction my areas of research are 1) Hip Arthroscopy and treatment of hip disorders, and treatment of labral tears in the treatment of hip pain. 2) Periacetabular osteotomy for the treatment of hip dysplasia.


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