Search

Psychological factors are receiving increased attention for their role in musculoskeletal health, surgical outcomes, and patient-reported outcome measures. This study examined if preoperative and 3-month postoperative pain catastrophizing, kinesiophobia, and self-efficacy differ between patients who report greater versus less than 75% overall improvement from baseline to 3 months after hip arthroscopy for femoroacetabular impingement syndrome. Of 43 patients, 13 (30.2%) reported p = .04), higher kinesiophobia (p = .02), and lower self-efficacy (p = .007) 3 months after surgery. None of the preoperative psychological factors differed between groups (p ≥ .67). Findings suggest that patients with maladaptive psychological responses 3 months following surgery may also perceive suboptimal surgical improvement.

Context: Femoroacetabular impingement syndrome (FAIS) is a painfully debilitating hip condition disproportionately affecting active individuals. Mental health disorders are an important determinant of treatment outcomes for individuals with FAIS. Self-efficacy, kinesiophobia, and pain catastrophizing are psychosocial factors that have been linked to inferior outcomes for a variety of orthopedic conditions. However, these psychosocial factors and their relationships with mental health disorders, pain, and function have not been examined in individuals with FAIS. Objective: (1) To examine relationships between self-efficacy, kinesiophobia, pain catastrophizing, pain, and function in patients with FAIS and (2) to determine if these variables differ between patients with and without a self-reported depression and/or anxiety. Design: Cross-sectional. Setting: University health center. Participants: Fifty-one individuals with FAIS (42 females/9 males; age 35.7 [11.6] y; body mass index 27.1 [4.9] kg/m2). Main Outcome Measures: Participants completed the Pain Self-Efficacy Questionnaire, Tampa Scale for Kinesiophobia, Pain Catastrophizing Scale, visual analog scale for hip pain at rest and during activity, and the 12-item International Hip Outcome Tool. Self-reported depression and/or anxiety were recorded. The relationships between psychosocial factors, pain, and function were examined using Spearman rank-order correlations. Independent t tests and Mann–Whitney U tests were used to evaluate the effect of self-reported depression and/or anxiety on psychosocial factors, pain and function. Results: The 12-item International Hip Outcome Tool was correlated with pain during activity (ρ = −.57, P ≤ .001), Tampa Scale for Kinesiophobia (ρ = −.52, P ≤ .001), and Pain Self-Efficacy Questionnaire (ρ = .71, P ≤ .001). The Pain Self-Efficacy Questionnaire was also correlated with pain at rest (ρ = −.43, P = .002) and pain during activity (ρ = −.46, P = .001). Individuals with self-reported depression and/or anxiety (18/51; 35.3%) had worse self-efficacy and pain catastrophizing (P ≤ .01). Conclusion: Self-reported depression and/or anxiety, low self-efficacy, and high kinesiophobia were associated with more hip pain and worse function for patients with FAIS. These findings warrant further examination including psychosocial treatment strategies to improve the likelihood of a successful clinical outcome for this at-risk population.

Over the past 10–15 years, many aspects of total hip arthroplasty (THA) have changed. First and foremost, the patients themselves have changed. Since 1990, the age group that has demonstrated the greatest increase in THA was patients between the ages of 45 and 64. As younger, healthier patients are having surgery, a greater emphasis is being placed on postoperative function, activity, and exercise. The rationale for increased postoperative activity is 2-fold: the obvious cardiovascular benefits of exercise and greater patient desire to return to recreational sporting activities. The purpose of this review is to discuss how recent changes in surgical technique, implant design, and pre- and postoperative rehabilitation have affected postoperative athletic activity for THA patients. Although these topics have been addressed often in the orthopedic literature, to our knowledge no published articles have summarized this information for a targeted audience of rehabilitation specialists.

Context:Decelerating movements such as landing from a jump have been proposed to be a common mechanism of injury to the anterior cruciate ligament (ACL).Objective:To compare eccentric hip-abductor strength and kinematics of landing between men and women when performing a hopping task.Setting:Research laboratory.Patients:18 healthy subjects (10 women, 8 men).Main Outcome Measures:Eccentric peak torque of the hip abductors and peak knee-joint angles during a 350-millisecond interval after impact.Results:No significant sex differences were present, but there was a significant inverse relationship between women's eccentric peak torque and peak knee-valgus angle (r = –.61, P = .03).Conclusions:Women with larger eccentric peak torque demonstrated lower peak knee-valgus angles. By not reaching as large of a valgus angle, there is potentially less stress on the ACL. Increasing eccentric hip-abductor strength might improve knee-joint kinematics during landing from a jump.