No Difference Between Surgery or Physical Therapy for Hip Impingement

hip-impingement-FAI-treatment

Hip impingement, or the compression of the soft tissue or bony structures of the hip joint, has become the flavor of the week in orthopedic surgery.  Surgical rates have risen 18 fold over the past ten years outpacing the available research on the condition.  Previous research has shown up 68% and 67% of asymptomatic hips will show labral tears and hip impingment, respectively.  The high rates of findings in asymptomatic patients, especially athletes, requires further research to determine if these changes are truly pathology or natural changes in athletic patient's hip joints.  Further, there has been no quality randomized trials between surgery and high quality Physical Therapy interventions until now.

Mansell and colleagues examined 80 patients with femoroacetabular impingement (FAI) syndrome over a 2 year period (Am J Sp Med. 2018).  Patients were randomized to receive either arthroscopic hip surgery with post operative Physical Therapy or Physical Therapy (twice per week x 12 weeks).  Both groups demonstrated improvements in pain and function, but no significant differences were found between groups were found at 2 year follow up.  Twenty patients from the Physical Therapy group eventually elected to have surgery but further analysis found this cross over did not alter the results.

This study highlights the importance of using Physical Therapy first for hip impingement.  To schedule your first appointment with the experts at MEND click here.