Acute and sub-acute changes in dynamic postural control following hip arthroscopy and post-operative rehabilitation."

CONTEXT Hip pain is associated with impairments in postural control and balance. The Star Excursion Balance Test (SEBT) is a reliable and valid method to measure dynamic postural control. OBJECTIVE Examine changes to dynamic postural control following hip arthroscopy and subsequent rehabilitation from pre-surgery to three and six months post arthroscopy. SETTING Sixty-seven individuals (47 men) scheduled for hip arthroscopy to address chondrolabral pathology were matched with sixty-seven healthy controls. The hip pain group underwent post-operative rehabilitation including SEBT training. MAIN OUTCOME MEASURES SEBT reach normalized to limb length was collected pre-surgery and at three and six months post surgery, and compared with healthy matched controls. Repeated measure analysis of variance (ANOVA) evaluated whether SEBT reach differed between the three time points and t-tests were used to evaluate between-limb and between-group differences. RESULTS Pre-surgical SEBT reach was significantly less than the control group in all directions (p<0.001). At three months post surgery, SEBT reach significantly increased in the posterior-lateral (PL) (p<0.001), anterior-lateral (AL) (p<0.001) and posterior-medial (PM) (p=0.006) directions from pre-surgery. At six months post surgery, all directions of reach had significantly increased (p<0.001) from baseline. Compared to the control group, AL (-2.5 %, p=0.038), anterior medial (AM) (-2.9%, p=0.019) and posterior-medial (PM) (-5.2%, p= 0.002) reach remained significantly less at six months post surgery. No significant difference existed between the control and surgical groups for reach in the PL (-3.6%, p=0.061) direction. CONCLUSIONS Pre-surgical dynamic balance control within a hip pain group was significantly poorer than matched controls as measured by the SEBT. At three months post hip arthroscopy, there were significant improvements in dynamic balance in the PM, PL and AL SEBT directions. By six months post surgery, all directions of SEBT reach had significantly improved but only PL reach improved to the level of healthy controls.