Abstract
Introduction: Functional testing is essential for determining the readiness for return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction, helping reduce re-injury risk and facilitate RTS activities. The Functional Lower Extremity Evaluation (FLEE is a validated assessment tool comprising various functional tests to evaluate lower limb function and symmetry. Despite its effectiveness in rehabilitation for other procedures, there remains a knowledge gap regarding RTS testing following hip arthroscopy, particularly the application of the FLEE in RTS rehabilitation following hip arthroscopy. This proof-of-concept study aims to assess the utility of the FLEE in guiding RTS rehabilitation protocols for collegiate athletes after hip arthroscopy and to evaluate lower limb symmetry using FLEE components.
Methods: A retrospective review of collegiate athletes who underwent hip arthroscopy for femoroacetabular impingement (FAI) was performed. Demographic data, including age, sex, height, weight, injured limb, limb dominance, and sport type were recorded. The 8-task FLEE was administered post-operatively to assess lower extremity function. FLEE components included timed lateral step-down, timed leap and catch, single-leg hop for distance, single-leg timed hop, single-leg triple hop for distance, crossover hop for distance, square hop test, and lower extremity functional test (LEFT). Percent limb symmetry was calculated for each FLEE component. RTS, re-injury and re-operations rates were monitored.
Results: This pilot study included 4 collegiate athletes (3 males, 1 female; mean age – 19 years). RTS testing revealed improvements in all FLEE components following the rehabilitation protocol for hip arthroscopy, with RTS achieved at a mean of 5.75 ± 1.44 months. There were no re-injuries or re-operations for the athletes after RTS with a mean follow-up of 52.89 months. Percent limb symmetry ranged from 97.95% to 110.04% across FLEE components.
Conclusion: The FLEE appears to be a valuable instrument for assessing lower extremity function and symmetry in college athletes undergoing RTS rehabilitation after hip arthroscopy. The findings in this pilot study suggest that the FLEE may aid in guiding individualized rehabilitation programs and monitoring progress towards RTS goals. Further research with larger cohorts, longitudinal follow-up and comparative studies is warranted to validate these findings and optimize RTS outcomes in this population.