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Randomized Controlled Trial
. 2017 Jun 23;7(6):e014658.
doi: 10.1136/bmjopen-2016-014658.

Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR)

Kim L Bennell  1 , Libby Spiers  1 , Amir Takla  2 , John O'Donnell  3 , Jessica Kasza  4 , David J Hunter  5   6 , Rana S Hinman  1
Affiliations
Randomized Controlled Trial

Efficacy of adding a physiotherapy rehabilitation programme to arthroscopic management of femoroacetabular impingement syndrome: a randomised controlled trial (FAIR)

Kim L Bennell et al. BMJ Open. .

Abstract

Objectives: Although several rehabilitation programmes following hip arthroscopy for femoracetabular impingement (FAI) syndrome have been described, there are no clinical trials evaluating whether formal physiotherapy-prescribed rehabilitation improves recovery compared with self-directed rehabilitation. The objective of this study was to evaluate the efficacy of adding a physiotherapist-prescribed rehabilitation programme to arthroscopic surgery for FAI syndrome.

Design: Randomised controlled trial.

Methods: People aged ≥16 years with FAI syndrome scheduled for hip arthroscopy were recruited and randomly allocated to physiotherapy (PT) or control. The PT group received seven PT sessions (one preoperative and six postoperative) incorporating education, manual therapy and a progressive rehabilitation programme of home, aquatic and gym exercises while the control group did not undertake PT rehabilitation. Measurements were taken at baseline (2 weeks presurgery) and 14 and 24 weeks postsurgery. The primary outcomes were the International Hip Outcome Tool (iHOT-33) and the sport subscale of the Hip Outcome Score (HOS) at week 14.

Results: Due to slower than expected recruitment and funding constraints, recruitment was ceased after 23 months. Thirty participants (14 PT and 16 control) were randomised and 28 (14 PT and 14 control; 93%) and 22 (11 PT and 11 control; 73%) completed week 14 and 24 measurements, respectively. For the 14-week primary outcomes, the PT group showed significantly greater improvements on the iHOT-33 (mean difference 14.2 units; 95% CI 1.2 to 27.2) and sport subscale of the HOS (13.8 units; 95% CI 0.3 to 27.3). There were no significant between-group differences at week 24.

Conclusions: An individual PT treatment and rehabilitation programme may augment improvements in patient-reported outcomes following arthroscopy for FAI syndrome. However, given the small sample size, larger trials are needed to validate the findings.

Trial registration number: Trial registered with the Australian New Zealand Clinical Trials Registry :ACTRN12613000282785, Results.

Keywords: FAI; arthroscopy; exercise; hip; physical therapy.

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Conflict of interest statement

Competing interests: AT and JOD developed the physiotherapy protocol that was tested and used this in their private clinical practices. JOD is the founder of the Australian Hip Arthroscopy Education and Research Foundation that provided financial support of the project. None of the other authors have any competing interests.

Figures

Figure 1
Figure 1
Participant flow through the trial. FAI, femoracetabular impingement.
See this image and copyright information in PMC

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