2025 ISAKOS Biennial Congress ePoster
Functional Lower Extremity Evaluation (Flee) in Return-To-Sport Rehabilitation Protocol Following Hip Arthroscopy in Collegiate Athletes: A Preliminary Study
Yazdan Raji, MD, San Mateo, CA UNITED STATES
Kinsley J Pierre, BS (Student), Stanford, California UNITED STATES
Floyd VitoCruz, MSPT, Stanford, CA UNITED STATES
Marc R. Safran, MD, Prof., Redwood City, CA UNITED STATES
Stanford University, Department of Orthopaedic Surgery, Redwood City, CA, UNITED STATES
FDA Status Not Applicable
Summary
This proof-of-concept study was to assess the utility of the FLEE in guiding RTS rehabilitation protocols for collegiate athletes after hip arthroscopy.
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Abstract
Introduction
Return-to-sport (RTS) assessment after hip arthroscopy requires comprehensive evaluation of lower extremity function to ensure optimal performance and reduced risk of re-injury. The Functional Lower Extremity Evaluation (FLEE) is a validated assessment tool comprising various functional tests designed to assess lower limb function and symmetry. However, there is a gap in knowledge in RTS testing following hip arthroscopy, particularly the application of the FLEE in RTS rehabilitation protocols following hip arthroscopy. The purpose of this proof-of-concept study was to assess the utility of the FLEE in guiding RTS rehabilitation protocols for collegiate athletes after hip arthroscopy and to evaluate lower limb symmetry using FLEE components.
Methods
A retrospective review of collegiate athletes who underwent hip arthroscopy for femoroacetabular impingement (FAI) was performed. Demographic and biometric data were recorded. The 8-task FLEE was administered post-operatively to assess lower extremity function. FLEE components included timed lateral step-down, timed leap and catch, single-leg hop for distance, single-leg timed hop, single-leg triple hop for distance, crossover hop for distance, square hop test, and lower extremity functional test (LEFT). Percent limb symmetry was calculated for each FLEE component. RTS, re-injury and re-operations rates were monitored.
Results
Four collegiate athletes (3 males, 1 female; mean age – 19 years) were included in this pilot study. Athletes demonstrated improvements in all FLEE components following rehabilitation, achieving RTS at a mean of 5.75 months ± 1.44 months. No re-injuries or re-operations occurred at a mean follow-up of 52.89 months. Limb symmetry ranged from 97.95% to 110.04% across FLEE components.
Conclusion
The FLEE appears to be a valuable instrument for assessing lower extremity function and symmetry in college athletes undergoing RTS rehabilitation after hip arthroscopy. The findings in this pilot study suggest that the FLEE may aid in guiding individualized rehabilitation programs and monitoring progress towards RTS goals. Further research with larger cohorts, longitudinal follow-up and comparative studies is warranted to validate these findings and optimize RTS outcomes in this population.