PATIENTS WITH FEMOROACETABULAR IMPINGEMENT SYNDROME OBTAIN SIGNIFICANT AND SUSTAINED IMPROVEMENT FOLLOWING A COMBINED HIP INJECTION AND REHABILITATION PROGRAM

Abstract

INTRODUCTION Initial treatment recommendations for symptomatic femoroacetabular impingement syndrome include non-surgical therapies such as injections and rehabilitation. However, many patients undergo isolated injections or a rudimentary exercise regime. This study investigated the benefit of a combined intra-articular hip injection and structured exercise rehabilitation program in patients with FAIS. METHODS Participants were recruited and underwent a guided intra-articular injection of corticosteroid and local anaesthetic, followed by a 12-week rehabilitation program. Patients were assessed pre-and post-injection(8 weeks, 4, 6, 12 and 24 months) via patient-reported outcome measures including the 33-item International Hip Outcome Tool and Hip Outcome score. Hip ROM and peak isometric hip strength in all planes were assessed, along with single-limb hop capacity. Limb Symmetry Indices were calculated. The percentage of patients transitioning toward surgery over the period was evaluated. RESULTS A total of 44 patients underwent the injection and completed the initial 8-week rehabilitation component. A significant improvement (p<0.05) in all PROMs was observed, with 93% of patients satisfied. A significant increase (p<0.05) in all active hip ROM and isometric strength measures was observed, sustained over the 24-month period. Bilateral improvements in hop capacity were observed, with all hop test LSIs significantly improving (p<0.05). Overall, 14 patients (32%) progressed toward surgical intervention over the 24-month post-injection period. These patients reported significantly worse (p<0.05) PROMs pre-surgery and more pain within the first 4 weeks post-injection. CONCLUSION This is the first study seeking to implement and comprehensively assess a best-practice, multimodal non-operative program consisting of an intra-articular injection and a structured exercise program. Most patients with symptomatic FAIS demonstrated significant improvement in symptoms.