Hip impingement (FAI) is one of the fastest growing orthopedic surgeries, but much of this growth has outpaced our current understanding of this condition. A key question involves the additional bone development (cam and pincer lesions) found among athletes. Many of these athletes remain asymptomatic despite having positive findings of impingement on x ray and other imaging techniques. Other athletes with FAI who are symptomatic often return to sport and high function after undergoing Physical Therapy indicating some individuals are able to compensate and adapt for these structural changes or they may be a natural response to the sport itself.
Previous research has found equivocal long term outcomes between Physical Therapy and surgery for hip impingement. This data indicates a significant duration (8-12 weeks) of Physical Therapy should be attempted before surgical interventions. The majority of athletes undergoing hip impingement surgery will return to sport around 6-10 months post surgery, but many will be unable to return to their pre injury levels of activity. Prior studies have found only half are able to return to their previous sports and 1 in 5 will be able to return to the same sport with the same level of performance. A recent study sought to understand how these individuals function 6-10 months after surgery.
The Orthopedic Journal of Sports Medicine followed 33 patients who underwent hip arthroscopy for conditions involving hip impingement (Worner et al. 2019). On average, patients were reassessed at 8 months post op and their subjective history and objective testing were compared to their age matched peers. Authors reported decreased subjective function and ability to return to sport in the surgical group. Specifically, 46% and 18% were able to return the same sport at a lower or similar level, respectively. Consistent with prior research these individuals regained strength and range of motion after post operative Physical Therapy except continued to experience decreased hip flexion strength and range of motion compared to their peers.
This study adds to our existing knowledge on the recovery following hip arthroscopy for hip impingement. Despite being cleared to return to sport many athletes will require additional recovery time to regain participation in sporting activities.