Background
Patients with symptomatic acetabular retroversion is reported having reduced functional ability and quality of life but little is known about the effect of non-surgical interventions.
Purpose/Aim of Study
To investigate feasibility and change in patient-reported symptoms of a home-based exercise intervention in patients with acetabular retroversion and excessive anterior pelvic tilt, in comparison with a prior control period.
Materials and Methods
Patients with symptomatic acetabular retroversion and excessive anterior pelvic tilt were included. Following an 8-week control period, patients were instructed to follow an 8-week targeted (3 times/week) progressive home-based exercise intervention. Feasibility assessment included; dropout, acceptable adherence (≥75% of sessions), exercise-related pain, and adverse events. Primary outcome was change in the Copenhagen Hip and Groin Outcome Score (HAGOS) pain subscale. Secondary outcomes included change in remaining HAGOS subscales, EQ-5D-3L questionnaire, and pelvic tilt measured by EOS® scanning.
Findings / Results
Forty-two patients (39 women) (median [interquartile range (IQR)], 20.5 [19 - 25 years]) were included. Three patients were lost to follow-up (one regretting participating during the control period, one during the intervention period and one patient was lost at follow-up). Adherence to exercise sessions was 85%. Exercise-related pain and adverse events were acceptable. Between-period mean change score for the HAGOS-PAIN subscale was 5.2 points (95% confidence interval [CI]:[-0.3 – 10.6] and -1.6 degree [-3.9 – 0.7]) of anterior pelvic tilt. Additionally, patients who responded positively (≥ minimal clinically important difference) to the exercise intervention (n = 10, 26%), all had a pre-exercise HAGOS-PAIN score between 47.5 to 70 points.
Conclusions
Current exercise intervention was feasible. However, no clinical relevant changes in self-reported hip-related pain, function, quality of life, nor anterior pelvic tilt were found. Post-hoc responder analysis revealed that patients with moderate pain at baseline might benefit from current exercise.