Results

At The Hip and Groin Clinic the well-being of your hips does not end after surgery.

All cases/athletes are monitored closely post-operatively at 3 months, 1 year, 2 years and 5 years after their hip surgery.

A number of internationally validated health questionnaires and repeated measurement of hip range of movements are utilised to assess the progress of athletes following surgery.

Validated Outcomes 2 &5 years post-surgery

All results shown in the outcomes graphs below demonstrate the median value (middle score from all cases) and the inter-quartile range (the range of the middle 50% of cases).

 

Harris Hip Score (HHS):

This is an assessment of pain, movement and function of the hip joint – best possible score = 100

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Median value and inter-quartile range (in brackets)

Poor preoperative hip function and high pain level is demonstrated by a median HHS of 76. Post-operative results show excellent return of function and resolution of pain with a median score of 96.

The improvement in HHS score following surgery shows a highly significant increase at 2 and 5 years (p<0.01).

 

UCLA Level:

This is an activity rating scale (1-10), assessing the physical activity levels of athletes where 1=wholly inactive; 10=regularly participates in impact sports.

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Median value and inter-quartile range (in brackets)

Summary:

Before surgery at least 75% of athletes are limited to what they can do, with more than half of all athletes restricted to a level of moderate activities such as swimming, limited walking/running (level 6) or less.

At 2 years following surgical intervention more than 50% of athletes are participating in impact sports such as regular training and involved in competitive matches etc. (level 9)

At 5 years following hip surgery, more than 50% of athletes are still at UCLA level 8 or above – involved in very active events such as cycling, running up to competitive sports.

The improvement in activity level following surgery shows a highly significant increase at 2 and 5 years (p<0.01).

 

SF-36:

This is a general health and well-being assessment, assessing how well a person is feeling and how well they are able to do their usual activities. (max score = 100)

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Median value and inter-quartile range (in brackets)

Summary:

Prior to surgery a low median score of 72 with an inter-quartile range from 58 – 83 indicates the significant physical and emotional toll FAI has on the athlete. Surgery results in enormous improvement in general wellbeing at 2 and 5 years post operation.

Achieving the maximum score of 100 for this assessment can often be difficult even with a pain free return to sports, due to the emotional toll which prolonged injury places on athletes.

There has been a highly significant increase in post-operative outcome SF36 scores at 2 and 5 years after surgery (p<0.01).

 

WOMAC:

This assessment highlights pain, stiffness and physical function of the hip. (best possible score = 0, worst score=100)

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Median and inter-quartile ranges shown (in brackets)

Summary:

Prior to surgery a median score of 19 with an inter-quartile range from 9 – 34 indicates the impact pain and particularly stiffness has on athletes performing daily activities. Surgery results in enormous improvement in pain, stiffness and physical function of the hip at 2 and 5 years post operation.

There has been a highly significant increase in post-operative outcome WOMAC scores at 2 and 5 years after surgery (p<0.01).

 

Range of movement (ROM)*

*2 years post-surgery

Flexion:

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Population mean = 123o± 9o

Patient mean (pre-op) = 112o ± 12o

Patient mean (post-op) = 117o ± 9o

Hip flexion is a movement that can be greatly restricted in the presence of bony abnormalities associated with hip impingement. Hip flexion has increased by 5o, from 112o before surgery to 117o at 2 years after surgery.

 

Abduction:

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Population mean = 45o± 8o

Patient mean (pre-op) = 45o ± 9o

Patient mean (post-op) = 48o ± 9o

Abduction is a movement that is not significantly affected by the bony constraints associated with hip impingement. Overall however, there has been a 3o increase in this movement in patients who have had surgery compared to the average range in an asymptomatic population.

 

Adduction:

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Population mean = 24o± 11.7o

Patient mean (pre-op) = 20.5o ± 8.6o

Patient mean (post-op) = 24.4o ± 6o

Adduction is increased among our athletes by 4o following surgery (from 20.5o to 24.4o). This average range of movement is now comparable to a ‘normal’ population/a group of individuals with no previous hip injury.

 

External Rotation:

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Population mean = 41.9o± 7.3o

Patient mean (pre-op) = 37.2o ± 8.8o

Patient mean (post-op) = 40.2o ± 7.8o

Often due to the location of the bony abnormalities, the External Rotation movement may not be so obviously restricted, as with the other movements. At 2 years following surgery there is an increase in this movement by 3o overall (from 37.2o to 40.2o) more consistent with a ‘normal’ population.

 

Internal Rotation:

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Population mean = 34o± 7o

Patient mean (pre-op) = 24.2o ± 11.5o

Patient mean (post-op) = 33o ± 9.7o

Internal Rotation can be one of the movements that is most notably restricted in the presence of the bony abnormalities associated with hip impingement.  With surgical intervention this movement is significantly increased. At 2 years following surgery an increase of 9o in this movement is maintained and is consistent with a normal, unaffected population.

 

Satisfaction:

All athletes are requested to complete a satisfaction questionnaire:

95% felt surgery was effective in relieving their pain

93% felt surgery increased their ability to perform regular activities

91% felt surgery allowed them to perform heavy work or sports activities

74% would definitely have the surgery again if needed on another joint -15% were ‘unsure’