DEVELOPING A SUCCESSFUL PREHAB INTERVENTION FOR FEMOROACETABULAR IMPINGEMENT: INTEGRATING LITERATURE, INTERNATIONAL CONSENSUS, AND PATIENT AND PUBLIC INVOLVEMENT

Hip preservation surgery for the management of Femoroacetabular Impingement Syndrome (FAIS) has grown in popularity in recent years. However, majority of patients do not achieve optimal outcomes due to various surgical and non-surgical factors. Although pre-operative interventions or Prehabilitation has been effective in improving outcomes in various Orthopaedic surgical procedures, its effectiveness in patients undergoing hip preservation surgery for FAIS is underexplored. PREHAB FAI is a feasibility study funded by the National Institute of Health and Care Research UK to address this knowledge gap. However, in line with the MRC framework for developing and evaluating complex interventions, it was imperative to develop the intervention prior to testing its efficacy. Therefore, the aim of this study was to develop a novel prehabilitation intervention through a systematic and rigorous process for patients with FAIS undergoing hip preservation surgery. The novel prehabilitation intervention for FAIS was developed by synthesising the literature around the effectiveness of prehabilitation in Orthopaedic surgical procedures, an international expert panel consensus statement, Patient and Public Involvement and grading exercises based on muscle activity during a variety of hip exercises. The systematic review and meta-analysis revealed that prehabilitation was effective in improving several pre-operative and post-operative outcomes in patients undergoing Orthopaedic surgery. The international consensus panel identified and recommended 6 core domains to be targeted in the prehabilitation programme. The patient and public involvement group played a crucial role in shaping the study design, content, and creating an information leaflet on prehabilitation. The final prehabilitation program combined insights from these sources and a thorough review of literature on the various exercises and its impact on muscle activation. This prehabilitation programme was developed by undergoing a rigorous process and is supported by evidence, a consensus statement and involvement from a PPI panel. The PREHAB FAI study will assess the feasibility, suitability, acceptability and safety of this novel intervention in patients with FAIS undergoing hip preservation surgery.