Conservative Management of Femoroacetabular Impingement
Femoroacetabular Impingement
About this trial
This is an interventional treatment trial for Femoroacetabular Impingement
Eligibility Criteria
Inclusion Criteria:
- The participants will include new and existing patients with a diagnosis of femoroacetabular impingement and are being seen for an outpatient consultation for consideration of hip arthroscopy surgery.
- From direct correspondence with Dr. Stubbs, criteria for formal diagnosis of FAI includes a combination of clinical diagnosis supported with radiography.
- Clinical examination typically consists of reported hip pain, decreased flexion (<95o), decreased internal rotation (<10o), and
- a positive anterior impingement test result (report of deep, anterior groin pain following combination of flexion, internal rotation, and adduction).
- Use of an alpha angle is also used as a distinct characteristic with patient's having an alpha angle of > 50-55 degrees at increased risk for FAI.
Exclusion Criteria:
- previous hip surgery;
- any other surgical procedure of the lower limbs in the prior 6 months;
- pre-existing disease state of the hip such as rheumatoid arthritis;
- fracture;
- congenital/developmental hip dysplasia;
- initiation of opioid analgesia or cortico-steroid or analgesic injection intervention for hip pain within prior 30 days;
- physical impairments unrelated to the hip preventing safe participation in exercise, manual therapy, walking or stationary cycling;
- advanced osteoporosis;
- body mass index > 38;
- significant cardio-pulmonary disease;
- cardiac pacemaker;
- stated inability to complete the proposed course of intervention and follow-up;
- insufficient English language skills to comprehend assessment tools;
- resident greater than 90 minutes from Wake Forest Baptist Medical Center.
- Individuals with contraindications to treatment with mobilization and manipulation
Sites / Locations
- Institute for Human Health and Sports Science Research
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Advice and home exercise
Manual Therapy Plus Exercise
All participants will be given a handout consisting of education about avoidance of certain activities as well as 3 stretches and 3 strengthening exercises to be performed as a home exercise program 2-3x/week
Participants in this group will be given the same handout consisting of education about avoidance of certain activities as well as 3 stretches and 3 strengthening exercises to be performed as a home exercise program 2-3x/week. Participants in this group will also receive 12 individualized physical therapy treatment sessions (2x/week for 6 weeks) consisting of both manual therapy and exercise directed at the hip and surrounding areas based upon findings from the initial examination. Participants will also be given additional exercises to be performed at home as directed by the treating physical therapist