Hip Pelvis.  2022 Mar;34(1):45-55. 10.5371/hp.2022.34.1.45.

The Short-term Outcomes of Physiotherapy for Patients with Acetabular Labral Tears: An Analysis according to Severity of Injury in Magnetic Resonance Imaging

• Kawai M
• Tateda K
• Ikeda Y
• Kosukegawa I
• Nagoya S
• Katayose M

• KMID: 2534872
• DOI: http://doi.org/10.5371/hp.2022.34.1.45

Abstract

Purpose
The aim of this study was to evaluate the short-term outcome of physiotherapy in patients with acetabular labral tears and to assess the effectiveness of physiotherapy according to the severity of the labral tear.
Materials and Methods
Thirty-five patients who underwent physiotherapy for treatment of symptomatic acetabular labral tears were enrolled. We evaluated the severity of the acetabular labral tears, which were classified based on the Czerny classification system using 3-T MRI. Clinical findings of microinstability and extraarticular pathologies of the hip joint were also examined. The International Hip Outcome Tool 12 (iHOT12) was use for evaluation of outcome scores pre- and post-intervention.
Results
The mean iHOT12 score showed significant improvement from 44.0 to 73.6 in 4.7 months. Compared with pre-intervention scores, significantly higher post-intervention iHOT12 scores were observed for Czerny stages I and II tears (all P<0.01). However, no significant difference was observed between pre-intervention and post-intervention iHOT12 scores for stage III tears (P=0.061). In addition, seven patients (20.0%) had positive microinstability findings and 22 patients (62.9%) had findings of extra-articular pathologies. Of the 35 patients, eight patients (22.9%) underwent surgical treatment after failure of conservative management; four of these patients had Czerny stage III tears.
Conclusion
The iHOT12 score of patients with acetabular labral tears was significantly improved by physiotherapy in the short-term period. Improvement of the clinical score by physiotherapy may be poor in patients with severe acetabular labral tears. Determining the severity of acetabular labral tears can be useful in determining treatment strategies.

Keyword

Hip joint; Femoroacetabular impingement; Physical therapy modalities; Conservative treatment; Magnetic resonance imaging