Left to right: S.Meyer, SSPA president; Mathilda Moret and Jonathan Fellay, students, winners of the Poster award, and Suzanne Gard, MSc, PT, Geneva. 

Left, F.Vanini, founding member of SSPA); N.Mathieu (SSPA vice-president, and, far right, S.Meyer, SSPA president, with a group of students, invited as staff members for the 2013 SSPA conference. 

Over 600 attendees gathered for the SONAFE conference in Sao Paulo. 

100 sports PTs participated in a 11+ prevention program pre-congress course with M.Bizzini (Switzerland, IFSPT-EB) 

From left to right : M.Bizzini (speaker, IFSPT-EB), E.Verhagen (Speaker, Netherlands), A.Nowotny (next SONAFE president, Brazil), J.Crupnik (AKD president, Argentina), P. Paz Villena Rodriguez (SOKIDE president, Chile), F.Tadiello (SONAFE president, Brazil), K.Gordon (speaker, USA)  

Mario Bizzini visiting Marcelo Bannwart (president of the congress; founding member of SONAFE) at the Brazilian Olympic Training Center in Sao Paulo, where he leads the rehab & sports PT department.

The SPNZ continues to share material from its excellent monthly newsletters to members with the IFSPT. Here is an excerpt from the recent Research Reviews.

Surgical Treatment of Femoroacetabular Impingement: A Systematic Review of the Literature
Clohisy, J. C., St John, L. C., & Schutz A. L. (2010). Surgical treatment of femoroacetabular impingement: A system-atic review of the literature. Clinical Orthopaedics Related Research, 468, 555-564. doi: 10.1007/s11999-009-1138-6

Article Review
Surgical management of femoroacetabular impingement (FAI) is becoming more popular; however the literature sur-rounding its efficacy is still disputed. This review investigates hip impingement surgery its outcomes, complications and causes of failure.

FAI is the occurrence of abnormal femoral head and acetabulum abutment, resulting in damage to the articular carti-lage and/or the labrum. FAI is commonly classified into three forms cam, pincer and mixed impingement deformity. These deformities initiate a cascade of degenerative, intra-articular events including disruption of the labrochondral junction and potentially the development of secondary osteoarthritis (OA).

Eleven studies were reviewed with a mean follow up of 3.2 years. The current evidence regarding FAI surgery is rel-atively small, single-surgeon studies including retrospective case series and comparative designs. There were 496 cases of FAI amongst the studies. Across the articles techniques used to treat FAI were: periacetabular osteotomy, acetabular rim trimming, proximal femoral osteotomy, femoral osteochondroplasty and relative neck lengthening. Surgeries done supplementary to FAI repair were Microfracture, chondroplasty and partial labral resection/recontouring. With such a variety of surgical procedures it is difficult to compare these results.

The Merle d'Aubigne�-Postel score was the most commonly used clinical outcome measure (four of 11 studies). The average improvement in this questionnaire was between 2.4 to 5 points. Other questionnaires used were the WOM-AC osteoarthritis index (three studies) and the nonarthritic hip score (three studies). These outcomes had mean im-provements of 7 to 20.2 points and 14 to 31.3 points, respectively.

Factors associated with a good outcome and increased satisfaction included no or mild secondary osteoarthritis, la-bral refixation for treatment of labral pathology, young age, and limited cartilage damage. Failure was defined as ei-ther residual pain, conversion to a total hip arthroscopy (THA) or worsening OA, failure was seen on average in 4.4% of patients. Conversion to THA was reported in 0% to 26% of cases. Radiographic osteoarthritis progression was reported in five studies and noted in 0% to 33% of cases. Factors associated with surgical failures and conversion to THA included more advanced preoperative osteoarthritis, advanced articular cartilage disease, older age, and more severe preoperative pain. In general, major complications were uncommonly reported yet occurred in 0% to 18% of the procedures. These included avascular necrosis, femoral head-neck fracture, loss of fixation requiring reoperation, trochanteric nonunion, failure of labral refixation, inadequate osteochondroplasty requiring surgical revision, deep infection, and symptomatic or clinically important limitation of hip motion from heterotopic ossification. Symptomatic hardware requiring removal was the only moderate complication reported. None of the studies reported minor complications.

Current evidence regarding FAI surgery is poor. Results however do show pain relief and improved function in 68-96% of post-surgical patients over short-term follow-up. Long-term results have not yet been published and are needed to determine durability and impact on OA progression. Patients with more advanced OA, articular cartilage disease, older age, and more severe preoperative pain do not show good results from this surgery and should be considered for either a conservative approach or a THA. In younger patients with less articular cartilage and bony degeneration surgical outcomes were positive, even more so if combined with a labral repair.

The reporting of complications was variable. There were major complications of up to 18% of patients in one study; however the mean risk was 2.7% of patients. In general, impingement procedures are reported to be relatively safe, with minimal risk for major perioperative complications. The impact of impingement procedures on a long-term basis has not yet been researched and the role of nonsurgical management needs more evidence. Future clinical trials are needed to determine the relative efficacy of long-term nonsurgical and surgical treatment.

Reviewed by Monique Baigent BHsc (Physiotherapy)

Effect of Pre-operative Physiotherapy in Patients With End Stage Osteoarthritis Undergo-ing Hip Arthroplasty
PE Ferrrara, A Rabini, L Maggi, DB Piazzini, G Logroscino, G Maglioccheti Lombi, E Amabile, G Tancredi, AG Auli-sa, L Padua (2008) Clinical Rehabilitation, 22: 977-986

Article Review
Current management guidelines for osteoarthritis confirm the effectiveness of strengthening exercises and general physical activity to optimise functional status and reduce pain, although a lot of patients do progress to requiring sur-gery. Research is non-conclusive when analysing pre-operative physiotherapy strengthening in hip joint replace-ments, with results ranging from not useful, little benefit, to faster functional recovery, reduces amount of assistance and support post operatively, and reduces patient anxiety. The aim of this study is to measure changes in impair-ment, pain and quality of life in patients with end stage hip osteoarthritis pre and post hip replacement after partaking in preoperative physiotherapy.

Patients were recruited from the waiting list of an orthopaedic department and had been diagnosed with end stage osteoarthritis. Each study participant was evaluated at one month before surgery, the day before surgery, and 15 days, 4 weeks and 3 months post-surgery. Patients were randomised into control and study groups. Objective measures taken were:

• muscles strength of hip abductors and quadriceps
• ROM of hip abduction and external rotation
• Barthel Index, to measure disability
• Quality of life using SF-36
• Impairment using Western Ontario and McMaster Osteoarthritis Index (WOMAC)
• Pain using VAS

The study group attended a pre-operative physiotherapy programme involving group and individual sessions for 5 days/week. Following surgery both groups performed a 4 week inpatient rehabilitation programme.

The study group attended a pre-operative physiotherapy programme involving group and individual sessions for 5 days/week. Following surgery both groups performed a 4 week inpatient rehabilitation programme. As expected the study group showed significant improvements after one month of pre surgery physiotherapy, in keeping with the cur-rent guidelines. At 3 months post op both groups showed a significant improvement in all outcome measures, howev-er the study group had a significantly lower VAS and higher hip external rotation when comparing the two groups.

Clinically this study shows that pre-operative physiotherapy programmes do not reduce impairment or improve quali-ty of life following hip joint replacement. Physiotherapy has an important role in the conservative management of hip osteoarthritis.

Reviewed by Deborah Nelson BPhty, PGD Musculoskeletal

For more information and to register, follow this link

No time to participate in conferences outside your clinic? No travel budget? No time for classroom study with family commitments?

The IFSPT has approved the SPTS Home Study Courses for credits toward International Sports Physical Therapy Registration...and IFSPT members receive a generous discount. Courses may be purchased and downloaded immediately...you can start learning right away.

Offered in a convenient downloadable format, each Home Study Course (HSC) consists of multiple chapters (monographs) along with a final examination. Chapters are approximately 15-30 pages in length and require 4 to 6 hours to complete. The final examination consists of approximately 5 questions from each chapter. To receive continuing education credit, HSC participants must complete the final examination and return the answer sheet to the SPTS home office via email or fax. A course certificate will be sent to the course participant upon successful completion of the final examination. Course participants must score 80% on the final examination in order to receive a course certificate. Five credit hours per chapter (monograph) are awarded upon successful completion...for example, a six chapter course receives thirty credit hours.

The SPTS Sports Certified Specialist Examination Preparatory Course

Editors: Robert C. Manske, PT, DPT, MEd, SCS, ATC, CSCS and Timothy Tyler, PT,  MS, ATC

Designed for preparation for the Sports Certified Specialist Examination in the United States, this fourteen-chapter course covers many areas the average clinician does not experience in daily practice 

 

NEW! CURRENT CONCEPTS IN SHOULDER REHABILITATION 

Editor: Chuck Thigpen PT, PhD, ATC

 

RUNNING 

Editors: Bryan Heiderscheit, PT, PhD and Mitchell J. Rauh, PT, PhD, MPH, FACSM

 

 PEDIATRIC AND ADOLESCENT SPORTS MEDICINE: MANAGEMENT AND PREVENTION OF INJURIES UNIQUE TO THE YOUNG ATHLETE 

Editors: Donna  L. Merkel, PT, MS, SCS, CSCSand Joe Molony, PT, MS, SCS, CSCS

 

 CURRENT CONCEPTS IN EVALUATION, EXAMINATION AND REHABILITATION OF THE KNEE 

Editor: Robert C. Manske, PT, DPT, MEd, SCS, ATC, CSCS

 

 REHABILITATION OF THE HIP  

Editors: Lori Bolgla, PT, PhD, ATC and J. Craig Garrison, PT, PhD, SCS, ATC

 

REHABILITATION OF ARTICULAR CARTILAGE INJURIES OF THE KNEE 

Editor: Timothy Tyler, PT,  MS, ATC

 

 THE SPINE IN SPORTS 

Editor: Barb Hoogenboom PT, EdD, SCS, ATC

 

 INJURY PREVENTION IN SPORTS MEDICINE 

Editor: Mike Mullaney, PT

 

 REHABILITATION OF THE AGING ATHLETE 

Editor: J. W. Matheson, PT

 

 REHABILITATION CONCERNS FOR THE FEMALE ATHLETE 

Editor: Teresa L. Schuemann, PT, SCS, ATC, CSCS

 

 EMERGENCY RESPONSE FOR THE PHYSICAL THERAPIST 

Editor: Danny D. Smith, PT, DHSc, SCS, OCS, ATC

 

Other courses are available. To learn more about these courses, follow this link to the SPTS website.

Team Concept Conference Streaming Video: January 2014
The Female Athlete: February 2014