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Abstracts / Journal of Science and

31

utcomes following hip arthroscopy: A systematic reviewf the literature

. Kemp 1,2,∗, N. Collins 2, M. Makdissi 3, A. Schache 2, Z.achotka 4, K. Crossley 1,2

School of Physiotherapy, University of Melbourne,ustraliaSchool of Engineering, University of Melbourne, AustraliaCentre for Health Exercise and Sports Medicine, School ofhysiotherapy, University of Melbourne, AustraliaInternational Centre for Allied Health Evidence (iCAHE),delaide, Australia

Introduction: Hip pathology is a recognised cause of painnd reduced function in adults. Hip arthroscopy is rapidlyncreasing in occurrence and aims to improve pain and func-ion in people with intra-articular hip pathology. The purposef this study was to conduct a systematic review to inves-igate pain and physical function outcomes following hiprthroscopy with and without femoral osteotomy, for variousnd co-existing intra-articular hip pathologies.

Methods: A comprehensive search strategy was utilizedo identify studies that investigated hip arthroscopy for intra-rticular hip pathology. Only studies which followed patientsor at least three months and used patient-reported outcomesor pain and/or function were included. Scopus, MEDLINE,INAHL, PEDro, PubMed, Sportdiscus, Ausport, Googlecholar, PsychINFO databases and the full Cochrane Libraryere searched. The Downs and Black scale was used to rateethodological quality. Effect sizes were calculated where

ufficient data was present.Results: Of 40 suitable studies, 29 of moderate method-

logical quality were included. Fifteen studies investigatedip arthroscopy alone (i.e., no osteotomy performed). Ofhese, effect sizes could be calculated for two studies, witharge effects (3.12-5.46) noted at one to two year follow-up.or the remaining studies (13/15), post-operative improve-ents in pain and function were consistently reported

median improvements of 47%) over longer follow-uperiods (up to 10 years). Fifteen studies investigated hiprthroscopy with osteotomy. Effect sizes calculated forine of these studies showed mostly large effects (0.78-.93) over six to 28 months. Femoral and/or acetabularsteotomy appeared to produce similar short-term resultso those obtained for hip arthroscopy alone. The likeli-ood of improved outcomes was reduced in the presencef pre-existing osteoarthritis, for both non-osteotomy andsteotomy groups. Adverse events were minimal (7% of par-icipants in 12 studies) and were mostly transient neuropraxia83%).

Conclusions: The best available evidence indicates that

ip arthroscopy results in significant improvements in painnd function in patients with intra-articular hip pathology.

hile this improvement can be obtained up to 10 years post-

ctd

ine in Sport 14S (2011) e1–e119 e65

urgery for hip arthroscopy without osteotomy, the long-termollow-up (i.e., beyond three years) for hip arthroscopy withsteotomy is yet to be evaluated. The risk of adverse eventss not high. Further high-quality comparative studies areequired, particularly investigating the role of rehabilitationn this patient population.

oi:10.1016/j.jsams.2011.11.133

32

easures of physical function of the hip

. Kemp 1,2,∗, A. Schache 2, Z. Machotka 3, K. Crossley 1,2

Melbourne School of Physiotherapy, University of Mel-ourne, AustraliaMelbourne School of Engineering, University of Mel-ourne, AustraliaInternational Centre for Allied Health Evidence (iCAHE),delaide, Australia

Introduction: Tests of physical function of the hip areommonly used in clinical practice, yet knowledge of per-ormance on these tests in healthy people is generallynder-reported and the reliability of these tests in healthydults requires consideration. In healthy adults, this studyimed to: (i) evaluate the reliability of strength and range ofotion measures of hip function; (ii) compare the differences

n these measures between dominant and non-dominant sides;nd (iii) compare the ratio of strength between antagonisticip muscle groups of the dominant and non-dominant limbs.

Methods: The intra-rater and inter-rater reliability of clin-cal tests of hip function (range of motion and strength usinghand held dynamometer) were examined and ICC and SEMalues established. Subsequently, in tests with good reliabil-ty, values of strength and range of motion were establishedn healthy adults. The difference in these tests between domi-ant and non-dominant limbs, and between opposing muscleroups of the hip were established (p = 0.05).

Results: Good to excellent intra-rater and inter-raterelative reliability of ROM (intra-rater ICC = 0.82–0.92;nter-rater ICC = 0.72–0.92) and strength (intra-raterCC = 0.83–0.98; inter-rater ICC = 0.86–0.97) were observedn all tests. In all tests of hip ROM, there was no differenceound between dominant and non-dominant limbs. In tests ofip strength, hip internal rotation at neutral hip flexion wasreater in the dominant leg (p < 0.05), but no other significantifferences were observed. Furthermore, strength of hipxternal rotators was significantly greater than hip internalotators in both dominant (p < 0.05) and non-dominantp < 0.05) limbs.

Conclusions: Reliable and meaningful measures of hiphysical function are essential for clinical practice. This studys important as it provides clinicians with a battery of reliable,

linically applicable tests to examine the physical function ofhe hip. In addition, it provides clinicians with a set of valuesescribing the normal physical function of the hip that can