FEMOROASETABULAR İMPİNGEMENT SENDROMUNDA FİZYOTERAPİNİN ETKİNLİĞİ

Femoroasetabular impingement sendromu (FAİS) kalça ekleminin iki bileşeni olan asetabulum ve femur proksimali arasındaki mekanik uyumsuzluk nedeniyle kalça ağrısı öncülü bir patolojidir. Özellikle genç erişkinlerde ve aktif kişilerde görülmektedir. Erken dönemde tanı konulmasıyla tedavi edildiğinde osteoartritin gidişi büyük ölçüde engellenebilmektedir. Femoroasetabular impingement sendromunun cam (femur tipi), pincer (kıskaç tip) ve her iki patolojinin bir arada görüldüğü durum olan miks tip olmak üzere 3 tipi vardır. Klinik hikaye, semptomlar, testler ve radyolojik görüntüleme ile beraber tanı konulmaktadır. Tanı sonrası dönemde; ağrı kontrolü, fizyoterapi ve rehabilitasyon uygulamaları, aktivite modifikasyonu, eklem içi enjeksiyon uygulamaları ve non-steroid antiinflamatuar ilaç kullanımı konservatif tedavi seçeneklerini oluşturmaktadır. Tedavi protokolünde konservatif tedavi yaklaşımlarının yetersiz kaldığı durumlarda cerrahi yöntemler önerilmektedir. İmpingement tipine göre çeşitli cerrahi seçenekler bulunmaktadır. Bu derleme makalede, femoroasetabular impingement sendromunda fizyoterapinin hastalar üzerindeki etkinliğinin değerlendirilmesi ve hastalar üzerinde çeşitli parametrelerdeki değişiklikler incelenmektedir.

___

  • Smith-Petersen MN. Treatment of malum coxae senilus, old slipped upper femoral epiphsis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. J Bone Joint Surg Am 1936;18(4): 869-80.
  • Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for ostoarthritis of the hip. Clin Orthop Relat Res 2003;(417):112-20.
  • Leunig M, Ganz R. Femoroacetabular impingement. A common cause of hip complaints leading to arthrosis. Unfallchirurg 2005;108(1):9-10, 12-7
  • Bredella MA, Ulbrich EJ, Stoller DW, Anderson SE. Femoroacetabular impingement. Magn Reson Imaging Clin N Am 2013;21(1): 45-64. (5)Philippon MJ, Stubbs AJ, Schenker ML, Maxwell RB, Ganz R, Leunig M. Arthroscopic management of femoroacetabular impingement: osteoplasty technique and literature review. Am J Sports Med. 2007;35:1571-80.
  • Dooley PJ. Femoroacetabular impingement syndrome nonarthritic hip pain in young adults. Can Fam Physician.2008;54:427.
  • Bedi A, Kelly BT. Femoroacetabular impingement. J Bone Joint Surg Am 2013;95(1):82- 92.
  • Ersan Ö., Yıldız Y., Ateş Y. Femoroacetabular impingement. TOTBİD Dergisi 2010;9(2):107-114.
  • Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetebular osteotomy. J Bone Joint Surg Am 2003;85-A(2):278-86.
  • Martin HD, Shears SA, Palmer IJ. Evaluation of the hip. Sports Med Arthrosc .2010;18:6375.
  • Parvizi J, Leuning M, Ganz R. Femoroacetabular impingement. J Am Acad Orthop Surg. 2007;15:56170.
  • Philippon M., Schenker M., Briggs K., Kuppersmith D. Femoroacetabular impingement in 45 professional athletes: associated pathologies and return to sport following arthroscoping decompression. Knee Surg Sports Traumatol Arthrosc 2007;15(7):908-14.
  • Janice K.L., Michael P.R. Conservative management of femoroacetabular impingement (FAI) in the long distance runner. Physical Therapy in Sport 15 (2014) 82e90. https://doi.org/10.1016/j.ptsp.2014.02.004
  • McCarthy, J. C., & Busconi, B. (1995). The role of hip arthroscopy in the diagnosis and treatment of hip disease. Orthop dics, 18(8), 753e756.
  • Lewis, C. L., Sahrmann, S. A., & Moran, D. W. (2007). Anterior hip joint force increases with hip extension, decreased gluteal force, or decreased iliopsoas force. Journal of Biomechanics, 40(16), 3725e3731. https://doi.org/10.1016/j.jbiomech.2007.06.024
  • Martin HD, Kelly BT, Leunig M, Philippon MJ, Clohisy JC, Martin RL et al. The pattern andtechnique in the clinical evaluation of the adult hip: The common physical examination tests of hip specialists. Arthroscopy.2010;26:16172.
  • Nicolas B., Philippe T., Joffrey C., Frederic M., Jean M.F., David D. Relationship between femoral offset and hip labral and chondral injury in painful non arthritic hip.
  • Fadul D.A., Carrino J.A. Imaging of femoroacetabular impingement. J Bone Joint Surg [Am] 2009;91 Suppl 1:138-43. https://doi.org/10.2106/JBJS.H.01449.
  • Amanatullah D.F., Antkowiak T., Pillay K., et al. Femoroacetabular impingement: current concepts in diagnosis and tr treatment. Orthopedics 2015; 38(3):185-99. https://doi.org/10.3928/01477447-20150305-07
  • Beck M, Kalhorm, Leuning M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: FAI as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:101218.
  • Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res 2004; (418):67-73.
  • Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck ofset. J Bone Joint Surg Br 2001;83(2):171-6.
  • Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res 2004;(418):61-6.
  • Khanduja V, Villar RN. The arthroscopik management of femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc. 2007;15:103540.
  • Wall PD, Fernandez M, Griffin DR, Foster NE. Nonoperative treatment for femoroacetabular impingiment: a systematic review of the literature.2013;5:418-426.
  • Emera K, Samir W, Motasem el H, Ghafar KA. Conservative treatment for mild femoroacetabular impingement. J Orthop Surg. 2011;1981:415.
  • Ayeni OR, Wong I, Chien T, Musahl V, Kelly BT, Bhandari M. Surgical indications for arthroscopic management of femoroacetabular impingement. Arthroscopy 2012;28(8):1170-9.
  • Kelly B.T., Williams R.J. III, Philippon M.J. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med 2003 31:1020–1037. https://doi.org/10.1177/03635465030310060701
  • Casartelli NC, Leunig M, ıtem-Glatthorn JF, Lepers R, Mafivletti NA. Hip flexor muscle fatique in patients with symptomatic femoroacetabular impingement. Int Orthop. 2012;36:96773.
  • Pierannunzii L. Pelvic posture and kinematics in femoroacetabular impingement: a systematic review. J Orthop Traumatol. 2017 Sep;18(3):187-196. https://doi.org/10.1007/s10195-016-0439-2
  • Beck E.C., Nwachukwu B.U., Krivicich L.M., et al. Preoperative hip extension strength is an independent predictor of achieving clinically significant outcomes after hip arthroscopy for femoroacetabular impingement syndrome. Sports Health. 2020; 12:361–72. https://doi.org/10.1177/1941738120910134
  • Enseki K.R., Kohlrieser D. Rehabilitation following hip arthroscopy: an evolving process. Int J Sports Phys Ther 2014; 9: 765–73.
  • Spencer-Gardner, L., Eischen, J.J., Levy, B.A. et al. A comprehensive five-phase rehabilitation programme after hip arthroscopy for femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 22, 848–859 (2014). https://doi.org/10.1007/s00167-013-2664-z
  • Bennell K.L, O’Donnell J.M., Takla A. et al. Efficacy of a physiotherapy rehabilitation program for individuals undergoing arthroscopic management of femoroacetabular impingement—the FAIR trial: a randomised controlled trial protocol. BMC Musculoskelet Disord 2014; 15: 58. https://doi.org/10.1186/1471-2474-15-58
  • Kemp J.L., Coburn S.L., Jones D.M., Crossley K. M., The physiotherapy for femoroacetabular impingement rehabilitation STudy (physioFIRST): A pilot Randomized Controlled Trial. Journal of Orthopaedic and Sports Physical Therapy 2018; 48(4): 307-315
  • https://doi.org/10.2519/jospt.2018.7941
  • Grant L.F., Cooper D.J., Conroy J.L., The HAPI ‘ Hip artroscopy pre-habilitation intervention’ study: does pre-habilitation affect outcomes in patients undergoing hip arthroscopy for femoro-acetabular impingement? J Hip Preserv Surg 2017; 4(1): 85-92
  • https://doi.org/10.1093/jhps/hnw046
  • Guenther J. R., Cochrane C.K., Crossley K.M., Gilbart M.K., Hunt M.A., A pre-operative exercise intervention can be safely delivered to people with femoroacetabular impingement and improve clinical and biomechanical outcomes Physiotherapy Canada 2017; 26(3): 204-211
  • https://doi.org/10.3138/ptc.2016-34
  • Müller T. A., Puig J.T., Montero S.N., Sanz J. R., Morrera J. B., Mas J.M., Sanchez J.M., Botella J.M., Benefits of a spesific and supervised rehabilitation program in femoroacetabular impingement patients undergoing hip arthroscopy: A randomized control trial J Clin Med 2021;10(14): 3125
  • https://doi.org/10.3390/jcm10143125
  • Mallets E., Turner A., Durbin J., Bader A., Murray L., Short-term outcomes of conservative treatment for femoroacetabular impingement: A systematic review and meta-analysis Int J Sports Phys Ther 2019;14(4): 514-524
  • Hoit G., Whelan D.B., Dwyer T., Ajrawat P., Chahal J., Physiotherapy as an initial treatment option for femoroacetabular impingement Am J Sports Med 2020;48(8): 2042-2050
  • https://doi.org/10.1177/03635465198826