On-Ice Functional Assessment of an Elite Ice Hockey Goaltender After Treatment for Femoroacetabular Impingement.
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.


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


METHODS
Clinical research.


METHODS
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°).


CONCLUSIONS
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.


CONCLUSIONS
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.
Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan jtramer@umich.edu.
Joseph S
JS
Tramer
Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
Jessica M
JM
Deneweth
Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
David
D
Whiteside
Broward Orthopedic Specialists, Fort Lauderdale, Florida.
James R
JR
Ross
Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
Asheesh
A
Bedi
Human Performance Innovation Laboratory, School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
Grant C
GC
Goulet
D001182:Arthroscopy; D001696:Biomechanical Phenomena; D003198:Computer Simulation; D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006615:Hip / Q000502:physiology*; D006688:Hockey / Q000293:injuries*; D006801:Humans; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D013996:Time and Motion Studies; D055815:Young Adult
FAI; athlete; computed tomography; hip arthroscopy; kinematics