1. Investigación

(1) To assess the efficacy of a specific rehabilitation protocol for femoroacetabular impingement syndrome (FAIS), patients who underwent hip arthroscopy (HA) were compared with a control group. (2) Patients with symptomatic FAIS who were scheduled for HA were randomized either to a control group (n = 45, 66.6% men, 41.8 12.4 years) following a general post-surgical treatment protocol or to an experimental group (n = 45, 71.2% men, 40.9 7.6 years) following a specific rehabilitation protocol supervised by a physiotherapist. Range of motion (ROM), orthopedic tests and pain were assessed immediately before surgery and at 4 and 14 weeks after surgery. The hip functional status was assessed by the modified Harris Hip Score (mHHS) before surgery and at the end of follow-up. (3) At 14 weeks after surgery and compared with the control group, the experimental group showed a lower percentage of positives for hip provocation tests (15.6% vs. 46.6% on Faber test; 15.6% vs. 77.8% on Fadir test; 2.2% vs. 20% on Ober test, experimental vs. control group, p < 0.001), a greater improvement in mHHS (27.2 vs. 10.7 points, p < 0.001) and higher ROM for all the movements evaluated: flexion (99.6 12.2 vs. 89.6 4.5, p < 0.001), extension (20.6 5.8 vs. 13.3 2.6, p < 0.001), adduction (30.6 5.7 vs. 23.4 8.4, p < 0.001), abduction (43.4 10.7 vs. 32.8 8.4, p < 0.001) and both internal (28.2 8.5 vs. 18.7 6.1, p < 0.001) and external hip rotation (36.8 9.3 vs. 27.4 5.6. p < 0.001). The pain decreased after surgery for both groups, although the reduction was greater in the experimental group at the end of intervention (13.8 16.1 vs. 34.9 16.3 mm, experimental vs. control group, p < 0.001). (4) The specific and supervised rehabilitation program in patients with FAIS undergoing HA showed better benefits at 14 weeks of treatment than the benefits achieved by a care protocol in terms of pain reduction and recovery of hip motion.

La rehabilitación tras la artroscopia de cadera es un componente integral de los resultados clínicos del proceso. Existe una escasez de evidencia en torno a los protocolos de rehabilitación post-operatorios después de la artroscopia de cadera en síndrome de choque femoroacetabular (CFA). OBJETIVOS: Determinar y analizar el efecto sobre dolor y el rango de movilidad (ROM) de un tratamiento postquirúrgico protocolizado de fisioterapia en sujetos intervenidos de CFA mediante artroscopia frente a sujetos sin tratamiento de fisioterapia especializada. METODOLOGIA: Se realizó un estudio clínico analítico controlado y aleatorizado para analizar la relación causa-efecto del protocolo de fisioterapia propuesto en relación con el cambio en el dolor y el rango de movilidad (ROM) en sujetos intervenidos por CFA mediante artroscopia de cadera. La muestra es de 90 sujetos, 45 en grupo de control y 45 en grupo de intervención. Se utilizó goniometría digital para medición del ROM, test funcionales de Fadir, Faber y Ober, escalas de dolor EVA y cuestionario de Harris modificado para cadera. En todos los análisis se estableció un índice de significación de p<0,05. Todas las mediciones se realizan previamente a la intervención artroscópica por CFA y se repitió la evaluación a los 30 días y a los 90 días postcirugía. RESULTADOS: Las pruebas ortopédicas evaluadas mejoraron su resultado en el grupo intervención tras la aplicación del protocolo en mayor medida que el grupo control. La media del ROM aumentó en mayor grado en los sujetos del grupo intervención que en el de control. La media de dolor según escala EVA fue menor en el grupo de intervención que en el de control. CONCLUSIONES: El tratamiento postquirúrgico protocolizado de fisioterapia supervisado adaptado al CFA objeto de este estudio ha proporcionado una mayor efectividad en ROM, dolor, funcionalidad y tests ortopédicos que el tratamiento convencional. / Rehabilitation after hip arthroscopy is an integral component of the clinical outcomes of the process. There is a lack of evidence about post-operative rehabilitation protocols after hip arthroscopy in femoroacetabular impingment (FAI). OBJECTIVES: To determine and analyze the effect on pain and range of mobility (ROM) of a protocolized post-operative physiotherapy treatment in subjects undergoing arthroscopy for FAI versus subjects without specialized physiotherapy treatment. METHODOLOGY: A controlled and randomized clinical trial was conducted to analyze the cause-effect relationship of the proposed physiotherapy protocol in relation to the change in pain and range of mobility (ROM) in subjects undergoing hip arthroscopy for FAI. The sample was 90 subjects, 45 in the control group and 45 in the intervention group. Digital goniometry for ROM measurement, functional tests of Fadir, Faber and Ober, EVA pain scales and modified Harris questionnaire for hip were used. A significance index of p <0.05 was established for all analyzes. All measurements were made prior to the arthroscopic intervention for FAI, and the evaluation was repeated at 30 days and at 90 days postoperatively. RESULTS: The orthopedic tests evaluated improved their results in the intervention group after the application of the protocol to a greater extent than in the control group. Mean ROM increased to a greater extent in the subjects in the intervention group than in the control group. The mean pain according to EVA scale was lower in the intervention group than in the control group CONCLUSIONS: The protocolized postoperative treatment of supervised physiotherapy adapted to the FAI object of this study has provided a greater effectiveness in ROM, pain, functionality and orthopedic tests than the conventional treatment.