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On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement.
Sports Health 2015 Nov-Dec; 7(6):542-7SH

Abstract

BACKGROUND

Femoroacetabular impingement (FAI) is a major cause of performance inhibition in elite-level athletes. The condition is characterized by pain, osseous abnormalities such as an increased alpha angle, and decreased range of motion at the affected hip joint. Arthroscopic surgical decompression is useful in reshaping the joint to alleviate symptoms. Functional kinematic outcomes of sport-specific movements after surgery, however, are presently unknown.

HYPOTHESIS

The ability of an ice hockey goaltender to execute sport-specific movements would improve after arthroscopic surgery.

STUDY DESIGN

Clinical research.

LEVEL OF EVIDENCE

Level 5.

METHODS

An ice hockey goaltender was evaluated after arthroscopic correction of FAI on the symptomatic hip. Passive range of motion and radiographic parameters were assessed from a computed tomography-derived 3-dimensional model. An on-ice motion capture system was also used to determine peak femoral shock and concurrent hip joint postures during the butterfly and braking movements.

RESULTS

Maximum alpha angles were 47° in the surgical and 61° in the nonsurgical hip. Internal rotation range of motion was, on average, 23° greater in the surgically corrected hip compared with contralateral. Peak shock was lower in the surgical hip by 1.39 g and 0.86 g during butterfly and braking, respectively. At peak shock, the surgical hip demonstrated increased flexion, adduction, and internal rotation for both tasks (butterfly, 6.1°, 12.3°, and 30.8°; braking, 14.8°, 19.2°, and 41.4°).

CONCLUSION

On-ice motion capture revealed performance differences between hips after arthroscopic surgery in a hockey goaltender. Range of motion and the patient's subjective assessment of hip function were improved in the surgical hip. While presenting as asymptomatic, it was discovered that the contralateral hip displayed measurements consistent with FAI. Therefore, consideration of preemptive treatment in a presently painless hip may be deemed beneficial for young athletes seeking a long career in sport, and future work is needed to determine the costs and benefits of such an approach.

CLINICAL RELEVANCE

Surgical treatment of symptomatic FAI can achieve pain relief and improved kinematics of the hip joint with athletic activities. Additional studies are necessary to determine whether improved kinematics enhance the longevity of the native hip and alter the progression of osteoarthritic changes in those with asymptomatic FAI deformity.

Authors+Show Affiliations

Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan jtramer@umich.edu.Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.Broward Orthopedic Specialists, Fort Lauderdale, Florida.Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26502449

Citation

Tramer, Joseph S., et al. "On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement." Sports Health, vol. 7, no. 6, 2015, pp. 542-7.
Tramer JS, Deneweth JM, Whiteside D, et al. On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement. Sports Health. 2015;7(6):542-7.
Tramer, J. S., Deneweth, J. M., Whiteside, D., Ross, J. R., Bedi, A., & Goulet, G. C. (2015). On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement. Sports Health, 7(6), pp. 542-7. doi:10.1177/1941738115576481.
Tramer JS, et al. On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement. Sports Health. 2015;7(6):542-7. PubMed PMID: 26502449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement. AU - Tramer,Joseph S, AU - Deneweth,Jessica M, AU - Whiteside,David, AU - Ross,James R, AU - Bedi,Asheesh, AU - Goulet,Grant C, Y1 - 2015/03/10/ PY - 2015/10/27/entrez PY - 2015/10/27/pubmed PY - 2016/8/17/medline KW - FAI KW - athlete KW - computed tomography KW - hip arthroscopy KW - kinematics SP - 542 EP - 7 JF - Sports health JO - Sports Health VL - 7 IS - 6 N2 - BACKGROUND: Femoroacetabular impingement (FAI) is a major cause of performance inhibition in elite-level athletes. The condition is characterized by pain, osseous abnormalities such as an increased alpha angle, and decreased range of motion at the affected hip joint. Arthroscopic surgical decompression is useful in reshaping the joint to alleviate symptoms. Functional kinematic outcomes of sport-specific movements after surgery, however, are presently unknown. HYPOTHESIS: The ability of an ice hockey goaltender to execute sport-specific movements would improve after arthroscopic surgery. STUDY DESIGN: Clinical research. LEVEL OF EVIDENCE: Level 5. METHODS: An ice hockey goaltender was evaluated after arthroscopic correction of FAI on the symptomatic hip. Passive range of motion and radiographic parameters were assessed from a computed tomography-derived 3-dimensional model. An on-ice motion capture system was also used to determine peak femoral shock and concurrent hip joint postures during the butterfly and braking movements. RESULTS: Maximum alpha angles were 47° in the surgical and 61° in the nonsurgical hip. Internal rotation range of motion was, on average, 23° greater in the surgically corrected hip compared with contralateral. Peak shock was lower in the surgical hip by 1.39 g and 0.86 g during butterfly and braking, respectively. At peak shock, the surgical hip demonstrated increased flexion, adduction, and internal rotation for both tasks (butterfly, 6.1°, 12.3°, and 30.8°; braking, 14.8°, 19.2°, and 41.4°). CONCLUSION: On-ice motion capture revealed performance differences between hips after arthroscopic surgery in a hockey goaltender. Range of motion and the patient's subjective assessment of hip function were improved in the surgical hip. While presenting as asymptomatic, it was discovered that the contralateral hip displayed measurements consistent with FAI. Therefore, consideration of preemptive treatment in a presently painless hip may be deemed beneficial for young athletes seeking a long career in sport, and future work is needed to determine the costs and benefits of such an approach. CLINICAL RELEVANCE: Surgical treatment of symptomatic FAI can achieve pain relief and improved kinematics of the hip joint with athletic activities. Additional studies are necessary to determine whether improved kinematics enhance the longevity of the native hip and alter the progression of osteoarthritic changes in those with asymptomatic FAI deformity. SN - 1941-0921 UR - https://www.unboundmedicine.com/medline/citation/26502449/On_Ice_Functional_Assessment_of_an_Elite_Ice_Hockey_Goaltender_After_Treatment_for_Femoroacetabular_Impingement_ L2 - http://journals.sagepub.com/doi/full/10.1177/1941738115576481?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -