Our Summary

This research study looks at the effects of a specific type of hip surgery (hip arthroscopy for femoroacetabular impingement or FAI) in the military population. FAI can lead to hip pain and early joint wear and tear. The study wanted to see if certain pre-surgery characteristics could predict poorer outcomes after surgery, and whether poor outcomes were linked to a higher chance of medical discharge from the military.

The researchers looked back at the medical records of over 450 military personnel and dependents who had this surgery between 2009 and 2014. They found that 39% were able to return to duty, 18% were cleared to return to normal activities but didn’t stay in active duty, and 43% were referred to the Disability Evaluation System.

They found that higher rank and being male were linked to a higher chance of return to duty. In contrast, having a psychiatric diagnosis, needing a second surgery, having other medical conditions, and complaining of general pelvic pain were linked to a lower chance of returning to duty. They also found that Marine Infantry and Special Forces had higher return to duty rates compared to those in more sedentary roles.

They also found that, on average, pain ratings and self-reported function improved after surgery. However, those who were able to return to duty had significantly better scores than those who did not return. Only the more active and elite military populations had return to duty rates similar to those previously reported in athletes after this surgery.

In conclusion, this type of hip surgery can effectively reduce pain and improve function, but it may not lead to a high rate of return to full active duty, especially for women, those with psychiatric diagnoses, and those in more sedentary roles. Lower post-surgery scores are linked to a lower chance of return to duty.

FAQs

  1. What is the hip surgery the research study is focused on and what is its purpose?
  2. What pre-surgery characteristics were found to predict poorer outcomes after surgery?
  3. What were the findings of the study in terms of return to duty rates post-surgery among different groups of military personnel?

Doctor’s Tip

One helpful tip a doctor might tell a patient about arthroscopy is to follow the post-operative rehabilitation plan carefully. This may include physical therapy exercises, rest, and restrictions on certain activities to ensure proper healing and optimal outcomes. It’s important to communicate any concerns or changes in symptoms to your healthcare provider to address them promptly.

Suitable For

Patients who are typically recommended arthroscopy are those who have joint pain, stiffness, swelling, or instability that has not responded to non-surgical treatments such as rest, physical therapy, medications, or injections. Common conditions that may benefit from arthroscopy include torn cartilage (meniscus), damaged ligaments, inflamed joint lining (synovitis), loose bone fragments, and certain types of arthritis.

Specifically for hip arthroscopy for femoroacetabular impingement (FAI), patients who may benefit from this surgery are those experiencing hip pain, limited range of motion, and early joint wear and tear due to impingement of the hip joint. Patients with FAI may also have a history of hip injuries, hip dysplasia, or structural abnormalities in the hip joint.

It is important for patients to undergo a thorough evaluation by a healthcare provider specializing in orthopedic surgery to determine if arthroscopy is the appropriate treatment option for their specific condition. Each patient’s individual medical history, symptoms, and imaging studies will be taken into consideration when recommending arthroscopy.

Timeline

Overall, the timeline for a patient before and after arthroscopy for femoroacetabular impingement in the military population can be summarized as follows:

Before arthroscopy:

  • Patient experiences hip pain and early joint wear and tear
  • Patient undergoes medical evaluation and diagnosis of femoroacetabular impingement
  • Decision is made to undergo hip arthroscopy surgery

After arthroscopy:

  • Surgery is performed to address the impingement and relieve pain
  • Patient undergoes post-operative rehabilitation and physical therapy
  • Patient reports improvements in pain levels and function
  • Patient’s ability to return to duty in the military is assessed based on pre-surgery characteristics and post-surgery outcomes
  • Some patients are able to return to duty, while others may be referred to the Disability Evaluation System

It is important to note that factors such as rank, gender, psychiatric diagnoses, need for additional surgery, and level of physical activity can impact the likelihood of returning to duty after surgery. Additionally, post-surgery pain levels and self-reported function can affect the patient’s ability to return to full active duty.

What to Ask Your Doctor

  1. What are the potential risks and complications of hip arthroscopy for FAI?
  2. What is the expected recovery time and rehabilitation process after surgery?
  3. How likely am I to return to full active duty after this surgery?
  4. Are there any specific pre-surgery characteristics that could impact my outcomes?
  5. What are the success rates of this surgery in military personnel compared to other populations?
  6. Will I need any additional surgeries or treatments after this hip arthroscopy?
  7. How will my pain and function be monitored and assessed post-surgery?
  8. Are there any lifestyle changes or modifications I should make after the surgery to optimize my outcomes?
  9. How will my mental health and overall well-being be taken into consideration during the recovery process?
  10. Are there any specific exercises or physical therapy recommendations I should follow to enhance my recovery and return to duty chances?

Reference

Authors: Thomas DD, Bernhardson AS, Bernstein E, Dewing CB. Journal: Am J Sports Med. 2017 Dec;45(14):3298-3304. doi: 10.1177/0363546517726984. Epub 2017 Sep 22. PMID: 28937803