PTOTSLPOtherGait & posture2020

Altered gait mechanics are associated with severity of chondropathy after hip arthroscopy for femoroacetabular impingement syndrome.

Lindsey Brown-Taylor, Jordan Wilson, Michael McNally and 7 others

PMID 32044697

WHAT IT FOUND

Patients with moderate-to-severe cartilage damage after hip arthroscopy walked slower with less total limb loading.

Those with no or mild damage shifted load away from the hip to the ankle. Neither group reported better function than healthy controls.

Key findings

01The moderate-severe chondropathy group walked slower and demonstrated significantly lower involved limb Total Support Moment (TSM) than the no-mild group.

02The no-mild chondropathy group demonstrated a significantly higher contribution of the ankle to TSM on the involved limb compared to the moderate-severe and healthy control groups.

03Hip function scores did not differ between those with no-mild versus moderate-severe chondropathy, though both were worse than healthy controls.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

This was a secondary analysis of a longitudinal study, so it was not powered specifically for these gait comparisons. The response rate for recruitment was low (20%), and participants may not represent the average post-arthroscopy patient. Healthy controls did not undergo MRI, so it is unknown if they had subclinical cartilage damage. The criteria used to categorize 'moderate-severe' versus 'no-mild' chondropathy were determined by the authors and have not been validated in FAIS populations. Pre-operative gait data was not available, so it is unclear if these gait patterns existed before surgery or developed afterwards.

Declared interests

The study was supported by the NIH (Extramural) and Non-U.S. Government grants. No specific commercial conflicts of interest were reported in the provided text.

The easy way to misread this

Do not assume that patients with less severe cartilage damage have better outcomes. The 'no-mild' group showed altered gait mechanics (shifting load to the ankle) despite having similar self-reported function to the more severely damaged group, suggesting that compensatory movement patterns persist even when structural damage is less obvious.

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