Oral Presentation ANZBMS-MEPSA-ANZORS 2022

Comparative Effects of Surgical And Non-Surgical Therapy on Hip Contact Force For Femoroacetabular Impingement Syndrome (#26)

Azadeh Nasseri 1 , Laura Diamond 1 , Trevor Savage 1 , Tamara Grant 1 , Michelle Hall 2 , Kim Bennell 2 , Jilian Eyles 3 , Libby Spiers 2 , David Hunter 3 , David Lloyd 1 , David Saxby 1
  1. Griffith University, Gold Coast, QLD, Australia
  2. The University of Melbourne, Melbourne, VIC, Australia
  3. The University of Sydney, Sydney, NSW, Australia

Femoroacetabular impingement syndrome (FAIS) is a motion-related clinical disorder of the hip common in young active adults, whereby abnormal morphology of the femur and/or acetabulum can cause hip and groin pain, and physical dysfunction [1]. Both arthroscopy and non-operative care approaches are used to treat FAIS. However, the comparative effects of these treatments on hip joint loading have not been examined. Current study compared 12-month effects of arthroscopy versus non-operative physiotherapist-led Personalised Hip Therapy (PHT) on hip contact force (HCF) during walking.

A subset of the Australian FASHIoN trial [2], consisting of 38 individuals with FAIS, attended biomechanical testing sessions before and 12 months after they were randomised to receive either arthroscopy or PHT. Three-dimensional whole-body motion, ground reaction forces, and surface electromyography were acquired during walking. A neuromusculoskeletal modelling framework was used to estimate external biomechanics, lower limb muscle forces, and HCF. Two-way repeated measures analysis of variance applied through Statistical Parametric Mapping to compare the 12-month main effects of, and interactions between, treatment and time on HCF during the gait cycle.

There were no significant differences in HCF between the two treatment groups at follow-up. Both treatments resulted in statistically significant increase in HCF magnitude from baseline to follow-up, across most of the gait cycle. No interaction effects were found.

No differences between treatment groups at follow-up means both treatments similarly increased the HCF. Following arthroscopy and PHT, the average increase in HCF was ~0.87 and 0.91 BW, respectively. Due to lack of untreated control group, it is unclear whether the increased HCF seen in both groups was an effect of treatment or due to natural progression. However, HCF at follow-up were of comparable magnitudes to those previously reported in healthy controls [3] and we speculate the observed increase in HCF could be an effect of treatment.

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  1. Griffin et al, Br J Sports Med, 50(19):1169-1176, 2016.
  2. Hunter et al, BMC Musculoskelet Disord, 22(1):697, 2021.
  3. Savage et al, Med Sci Sport Exe, in press, 2022.