2015 ISAKOS Biennial Congress ePoster #906

Comparison of Pre-Operative Hip Range of Motion with and without General Anesthesia in Patients with FAI

Cecilia Pascual-Garrido, MD, Aurora, CO UNITED STATES
Vivek P. Chadaymmuri, BS, Broomfield, CO UNITED STATES
Lori A. Nacius, PA, Boulder, CO UNITED STATES
Omer Mei-Dan, MD, Boulder, CO UNITED STATES
University of Colorado, Aurora, Colorado, USA

FDA Status Not Applicable

Summary: Range of motion is a clinical tool that helps the surgeon quantify the severity of impingement and assist in directing towards the appropriate treatment option. However, it should be taken into account that more than 50% of patients normally present with reduced range of motion preoperatively than that obtained while under anesthesia

Abstract:

Introduction

Hip range of motion (ROM) is normally compromised in patients with FAI (femoroacetabular impingement). However, most of these subjective measurements are performed in clinic where patients are vulnerable to apprehension and muscle contraction. Purpose: Compare conventional preoperative ROM measurements with those measurements obtained under general anesthesia. Materials and Methods: Conventional preoperative hip ROM and ROM under general anesthesia (UA) were prospectively measured in 290 hips (145 patients) undergoing Hip arthroscopy. All measurements were performed bilaterally and by the same observer. All patients included in the study underwent a hip arthroscopy secondary to FAI. Overall, differences between pre-operative ROM and ROM UA were compared using paired t-test. Additionally, differences for each patient were assessed using a paired t-test. Results: There were 145 total patients, including 96 females and 49 males. Average age was 33 years old (range 14-60). When analyzing each patient independently, different range of motion between preoperative and UA was observed in >50% of the patients in all ROM positing measured (including flexion, IR and ER). Fifty one percent of the patients showed decreased range of motion in clinic for IR (39% of 1°-10°; 11% between 11°-20° and 2% >21° of difference). Sixty percent of patients also showed decreased flexion preoperatively (42% of 1°-10°; 15% between 11°-20° and 2% >21° of difference). External rotation was also compromised in 55% of the patients, being the most common with a difference of 11°-20°(46%). Overall no statistical difference was evident on ER: 48.07 (±9) vs ER (UA) 48.6 (±12) (p=0.4); IR: 15 (±12) vs IR (UA): 14(±14) (p=0.6); Abd: 42 (±7) vs Abd UA: 42(±6.7) (p=0.8); Flexion: 111 (±10) vs Flexion (UA): 110 (±12). Conclusion: Range of motion is a clinical tool that helps the surgeon quantify the severity of impingement and assist in directing towards the appropriate treatment option. However, it should be taken into account that more than 50% of patients normally present with reduced range of motion preoperatively than that obtained while under anesthesia.