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AOTW: Return to Sport after Hip Arthroscopy- Measuring Mental Preparedness

This week's article of the week discusses the psychological readiness to return to play (RTP) after a hip arthroscopy procedure. This is an important piece of the puzzle when analyzing a patient's readiness to return to play after surgery and their risk assessment for re-injury. After a patient receives medical clearance from their surgical team, psychological readiness should be analyzed first, followed by functional and objective testing. Prior to the publication of this article, I've used the SANE score (which has been used for ankle, knee and shoulder injuries) to assess readiness for RTP, but arguably only captures a small piece of the patient's mental state.

The Article

Jones, et al published this article in AJSM December 2019:

The Australian-based study looked at a psychological readiness to return to sport questionnaire (very similar to the ACL-RSI questionnaire used in my clinic) for hip scope procedures. They analyzed 145 participants that had undergone a hip arthroscopy within the last 1-24 months; they ranged from elite athletes to sedentary individuals.

The following questions are subjectively measured (0-100):

  1. Are you confident that you can perform at your previous level of sport participation?

  2. Do you think you are likely to re-injure your hip by participating in your sport?

  3. Are you nervous about playing your sport?

  4. Are you confident that you could play your sport without concern for your hip?

  5. Do you find it frustrating to have to consider your hip with respect to your sport?

  6. Are you fearful of re-injuring your hip by playing your sport?

The Findings

The preliminary assessment of this tool supports that the HIP-RSI is valid, reliable, and easily administered tool for assessing psychological readiness to return to sporting activity for patients after hip arthroscopy with a range of participation. This study did not indicate thresholds/cut off scores for readiness to return (i.e. we aim for 65% on the ACL-RSI)…. As one might imagine, more research is needed, but it’s a start!

The study noted that at baseline (~1 month post-op), participants that had received clearance from their orthopaedic consultant to return to sports were significantly less confident in their hip & abilities than those that delayed their return to play. This lack of confidence has been linked to higher re-injury rates in post-operative knees.

Whether you think you can or you think you can't, you're right. - Henry Ford

What tools do you use to analyze mental preparedness in a returning athlete?


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