Westermann RW, et al. Paper 27. Presented at: American Orthopaedic Society for Sports Medicine; July 13-17, 2022; Colorado Springs, Colo.
Westermann reports receiving research support from Smith & Nephew; being a paid consultant for CONMED Linvatec, Responsive Arthroscopy and Smith & Nephew; being on the editorial or governing board of American Journal of Sports Medicine and Arthroscopy; and being a board or committee member for the American Orthopaedic Society for Sports Medicine.
COLORADO SPRINGS, Colo. — Higher Y-balance scores are associated with improved patient-reported outcomes after surgery for femoroacetabular impingement and may help determine readiness for return to sport, according to presented results.
“There [are] few return to sport testing programs available in the present literature; most of that is focused on ACLs,” Robert W. Westermann, MD, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “This leaves little guidance to counsel athletes. Surgeons, primary care [and] sports medicine professionals and athletic trainers could use [guidance] for when it’s safe to return to sports after hip preservation surgery.”
Westermann and colleagues retrospectively analyzed data on 40 patients (mean age of 17.7 years) who underwent 47 arthroscopic hip surgeries for femoroacetabular impingement (FAI) between Dec. 2018 and May 2021. According to the study abstract, the most common sports were dance, softball and basketball. All patients received formal return to sport (RTS) testing between 4 months and 6 months postoperatively (average of 5.75 months).
Robert W. Westermann
Patient-reported outcomes (PROs) included IKDC, hip outcome score – sports specific subscale (HOS-SSS) and hip return to sports after injury (Hip-RSI) scores. Physical assessments to determine RTS readiness included isokinetic and isometric strength testing, rapid succession tuck jumps and dynamic Y-balance testing, which were adapted from the ACL literature, according to Westermann.
Overall, patients reported a 91% RTS rate at an average of 7.2 months. Mean preoperative alpha angles were 67.15°, while mean postoperative alpha angles were 41.37°. At initial testing, mean HOS-SSS score was 85.98.
Westermann and colleagues found posteromedial and posterolateral reach on Y-balance testing and compositive Y-balance scores were significantly associated with HOS-SSS scores at initial testing. However, researchers found no other associations between PROs or anatomic factors and RTS testing.
“Y-balance testing, if you’re familiar with using it in your ACL cohorts, you can easily incorporate this for your hip athletes following surgery for FAI,” Westermann added. “This Y-balance data can be incorporated into shared decision-making for athletic trainers and surgeons and the athletes to better counsel patients for when RTS may be safe,” he said.