Grant, Tamara M., Diamond, Laura E., Pizzolato, Claudio, Savage, Trevor N., Bennell, Kim, Dickenson, Edward J., Eyles, Jillian, Foster, Nadine E., Hall, Michelle, Hunter, David J., Lloyd, David G., Molnar, Robert, Murphy, Nicholas J., O’Donnell, John, Singh, Parminder, Spiers, Libby, Tran, Phong and Saxby, David J. (2022) Comparison of walking biomechanics after physical therapist–led care or hip arthroscopy for femoroacetabular impingement syndrome : a secondary analysis from a randomized controlled trial. The American Journal of Sports Medicine, 50 (12). pp. 3198-3209. doi:10.1177/03635465221120388 ISSN 1552-3365.

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Abstract

Background: Femoroacetabular impingement syndrome is characterized by chondrolabral damage and hip pain. The specific biomechanics used by people with femoroacetabular impingement syndrome during daily activities may exacerbate their symptoms. Femoroacetabular impingement syndrome can be treated nonoperatively or surgically; however, differential treatment effects on walking biomechanics have not been examined. Purpose: To compare the 12-month effects of physical therapist–led care or arthroscopy on trunk, pelvis, and hip kinematics as well as hip moments during walking. Study Design: Secondary analysis of multi-centre, pragmatic, two-arm superiority randomized controlled trial subsample; Level of evidence, 1. Methods: A subsample of 43 participants from the Australian Full randomised controlled trial of Arthroscopic Surgery for Hip Impingement versus best cONventional (FASHIoN trial) underwent gait analysis and completed the International Hip Outcome Tool (iHOT-33) at both baseline and 12 months after random allocation to physical therapist–led care (personalized hip therapy; n = 22; mean age 35; 41% female) or arthroscopy (n = 21; mean age 36; 48% female). Changes in trunk, pelvis, and hip biomechanics were compared between treatment groups across the gait cycle using statistical parametric mapping. Associations between changes in iHOT-33 and changes in hip kinematics across 3 planes of motion were examined. Results: As compared with the arthroscopy group, the personalized hip therapy group increased its peak hip adduction moments (mean difference = 0.35 N·m/body weight·height [%] [95% CI, 0.05-0.65]; effect size = 0.72; P = .02). Hip adduction moments in the arthroscopy group were unchanged in response to treatment. No other between-group differences were detected. Improvements in iHOT-33 were not associated with changes in hip kinematics. Conclusion: Peak hip adduction moments were increased in the personalized hip therapy group and unchanged in the arthroscopy group. No biomechanical changes favoring arthroscopy were detected, suggesting that personalized hip therapy elicits greater changes in hip moments during walking at 12-month follow-up. Twelve-month changes in hip-related quality of life were not associated with changes in hip kinematics.

Item Type:	Journal Article
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor:	Library Publications Router
Journal or Publication Title:	The American Journal of Sports Medicine
Publisher:	SAGE Publications
ISSN:	1552-3365
Official Date:	October 2022
Dates:	Date Event October 2022 Published 13 September 2022 Available 12 July 2022 Accepted
Volume:	50
Number:	12
Page Range:	pp. 3198-3209
DOI:	10.1177/03635465221120388
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access

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