Arthroscopic hip surgery rates have dramatically increased in the last decade due in part to increased MRI imaging. MRIs are very sensitive, but lack specificity in many musculoskeletal disorders with high rates of false positives among asymptomatic populations. Hip pathologies such as impingement (cam or pincer) and labral tears can be found in up to 68% of patients without hip pain. As we described in our previous blog posts, many patients with these pathologies are able to improve pain and function with Physical Therapy alone. Further, authors report no differences in long term outcomes between surgery and Physical Therapy. A new study highlights the importance of post operative Physical Therapy in patients who do not respond to conservative treatments.
Rhon and colleagues followed patients who underwent hip arthroscopic surgery between 2004 and 2013 to determine their outcomes and healthcare utilization (Physical Therapy. 2018). The authors reported on 1870 patients of which 83% received Physical Therapy alone, 72% received opioid medication, and 56% received both Physical Therapy and opioid medication. Authors reported a $5000 savings on healthcare expenditure, a reduction in subsequent hip surgeries, and opiod utilization among patients receiving Physical Therapy first. Not surprisingly, patients receiving opioids first utilization more medication, over a longer period of time compared to patients receiving Physical Therapy.