The effectiveness of physiotherapy and rehabilitation program after arthroscopic surgery in patients with femoroacetabular impingement syndrome

This study was to carried out to evaluate pain, muscle strength, range of motion (ROM) and hip-functions and was to determine the effect of postoperative physiotherapy and rehabilitation on 24 patients undergone artroscopic surgery for Femoroacetabular Impingement Syndrome (FAI). The patients were divided into two groups randomly as the Physiotherapy Group and the Home Exercise Group each of consisting of 12 patients. There were 4 female and 8 male in the Physiotherapy Group with a mean age of 39,258,05 years (32-54 years); and 6 female and 6 male in the Home Exercise Group with a mean age of 36,337,46 years (24-51 years). All patients in both groups had the same postoperative home-exercise program, and the Physiotherapy Group had an additional active rehabilitation program by the physiotherapist twice a week for 6 weeks. All patients were evaluated for pain, ROM, muscle strength and hip functions preoperatively and at 6th week and 6th month postoperatively. All results taken from the measurements have been analyzed within the groups and with the groups. There were significant differences in all parameters for both groups on the assessment of postoperative 6th months compared to the preoperative assessment (p<0,01). Pain intensity level, ROM (hip abduction and adduction) and Harris Hip Score in the Physiotherapy Group showed significant improvements on the assessment of postoperative 6th week regarding to preoperative assessment (p<0,05; p<0,01). Night-pain intensity level (p<0,01), hip flexion and abduction ROM (p<0,05), hip flexors, internal and external rotator strength (p<0,05; p<0,01) and Harris Hip Score in the Physiotherapy Group were better than the Home Exercise Group on postoperative 6th week. At the 6th month postoperatively, all pain scores (p<0,05; p<0,01), ROM of hip internal and external rotation (p<0,05) and, hip flexor, extensor, abductor, adductor and external rotator muscle strength (p<0,05;p<0,01) in the Physiotherapy Group improved better than the Home Exercise Group. In addition, it was observed that the most significant improvements seen for the 4 parameters were between postoperative 6th weeks and 6th month assessments for the both groups. Depending upon all these results, it has been proven that an additional rehabilitation program given by physiotherapist to the home exercise program may be more effective for pain level, ROM, muscle strength and functional outcomes of these patients in both short and long term periods. The initiation of the improvements was seen at 6th weeks and was the highest at 6th months revealed that the importance of active rehabilitation program by the physiotherapist not just in early term and also intermediate and late terms. There needed to have randomized controlled future studies which include detailed and more frequent assessments with long-term follow-ups. Key Words: Femoroacetabular Impingement Syndrome, Hip Functions, Hip Exercises, Postoperative Rehabilitation