All right, so moving right along to our research sections from some abstracts. We're going to have Dr. Michael Banfield come up here and give our first abstract presentation. All right, guys, good to see everyone. And welcome to Anna. And I'm going to be talking about outcomes accelerated versus conservative rehabilitation protocols following arthroscopic surgery for ephemeral acetabular impingement. This is a project that one of my former fellows, Andrew Goels, has performed at Cedars-Sinai Crillin-Jobe Institute in Los Angeles. My disclosures are on the academy website. And just with regard to a little bit of background, we know that proper rehab is essential to the surgeries you perform, particularly hip arthroscopy, with regard to successful return to activity, return to sport, as well as improved PROs. The shortcomings of a lot of these PT protocols is that we have lack of sufficient detail, lack of reporting of the PROs, and a lot of variability in what we're doing. That's because most of this is expert opinion or personal experience, as opposed to utilizing evidence-based protocols. So we did develop a protocol. It was an accelerated protocol that we advanced from doing a more conservative protocol, where we had this be criteria-based and really tried to look at this and see if we have any worsening outcomes, such as complications with having this more accelerated program. So the purpose of the study was to compare the PROs following hip arthroscopy with this evidence-based reproducible accelerated program versus a more conservative protocol that was utilized previously. And our hypothesis was that there would be very similar PROs and no increase in complications. Inclusion criteria included all hip arthroscopy cases that were done from April of 2018 to March of 2021. We excluded dysplastic cases, history of fractures, concomitant to extra-articular procedures, microfracture AVN, as well as if we did bilateral hip arthroscopies, which were not numerous. Fourth regard to our data collection, we looked at the demographic information, surgical details, if they had any complications, including revision surgery. And then PROs were the VAS sane, as well as the modified Harris hip score. The conservative protocol was from April 2018 to March of 2020. This is a 50% weight-bearing with crutches protocol for three weeks. They utilized the hip hinge brace. We also typically did not start physical therapy for the first two to three weeks, versus our current accelerated program that was immediately weight-bearing with crutches, weight-bearing as tolerated, that is, in an earlier progression to physical therapy within one to two days after surgery. And really, not a lot of restrictions with regard to full range of motion or strengthening. I just told them to avoid extremes of motion when they're doing their physical therapy or other activities. We also looked at the MCID and utilized this distribution method to calculate this to compare the differences between the two groups. And what we found, just with regard to all of our patient characteristics, they're very similar. There's slightly less females in the accelerated group, slightly more left tips in the, or less left tips in the accelerated group, and a little bit more chondroplasty in that accelerated group. As far as our PROs, both groups combined had significant improvement from preoperative to postoperative values, as well as each group looked at separately. And then we did this propensity score because it was a non-randomized study to try to get rid of any sort of compounders. And what we found, interestingly, is that compared to the conservative group, the accelerated group did have slightly decreased or increased VAS scores at the one-year mark, as well as slightly decreased SANE and modified Harris-Hipps scores. But if we compared this between-group difference to the MCID, it really wasn't significant. So although there was statistical significance there, there was no clinical significance. So on the VAS, modified Harris-Hipps score, as well as the SANE. So with regard to our limitations, this was retrospective, no randomization. We did utilize that propensity score to account for that. Small sample size, decline in response rate, just like all of our PRO collections typically are. And then no isolation of rehab parameters in that. We don't know if it was increased weight-bearing versus strengthening versus range of motion, the most important parameter that we were looking at. So in conclusion, mean change from baseline statistically improved at various time points for all PROs. In favor of that conservative group in a statistical manner. But these differences were not large enough to be clinically significant. So we still utilize the accelerated protocol. Patients seem to prefer it. It resulted in similar functional outcomes, pain and rate of revision surgery, and allowed for earlier weight-bearing. And we all know that most of our patients, no matter what we tell them, are not too compliant. So probably better to direct them one way or the other. Thank you. All right.

accelerated rehabilitation protocol

conservative rehabilitation protocol

femoroacetabular impingement (FAI)

patient-reported outcomes (PROs)

hip arthroscopy