Hip Arthroscopy Followed by 6-Month Rehabilitation Leads to Improved Periarticular Muscle Strength, Except for Abductors and External Rotators

Abstract

PurposeTo evaluate the variations in hip muscles strength following arthroscopy and 6-month rehabilitation in patients treated for femoroacetabular impingement (FAI) MethodsA retrospective analysis was carried out on a series of patients who were arthroscopically treated for FAI at La Tour Hospital between 2020 and 2022. Bilateral isometric strengths of eight hip-related muscles (abductors, adductors, hamstrings, quadriceps, extensors, flexors, internal and external rotators) were assessed using a handheld dynamometer before surgery and postoperatively after six months of rehabilitation in terms of relative strength changes between time-points. ResultsA total of 29 patients (aged 26.9±7.1, 86% of women) were included. Except for the abductors which remained of comparable strength than before surgery, a statistically significant (p<0.05) increase in hip muscles strength on the operated side could be noted at 6 postoperative months for hamstrings (9%±17%, p=0.041), quadriceps (11%±27%, p=0.045), extensors (17%±32%, p=0.006), flexors (17%±29%, p=0.003), adductors (18%±23%, p<0.001), and internal rotators (32%±36%, p<0.001). The proportion of patients who reached a strength level above their pre-operative status ranged from 62% (quadriceps) to 86% (adductors and flexors) depending on the muscle studied. The external rotators were the only muscles that remained significantly weakened at 6 months on both operated (-13%±26%, p=0.002) and non-operated (-17%±25%, p<0.001) sides, with a decrease beyond 15% in almost half of the patients (45% and 48% respectively). ConclusionsArthroscopic treatment followed by 6-month rehabilitation granted to most FAI patients a higher strength level for several hip muscles, except for abductors and external rotators which remained comparable and weakened, respectively.