Rehabiliation vs Surgery for Recurrent Snapping Hip in A 26-Year-Old Man with Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome Hypermobility Type: A Biomechanical Study

Recurrent snapping hip is a common clinical presentation of localized joint hypermobility and it is presumed to be more common in patients with generalized forms of joint hypermobility, such as joint hypermobility syndrome/EhlersDanlos syndrome, hypermobility type (JHS/EDS-HT). This case study aimed was to show the effects of rehabilitation on a 26-year-old man with recurrent snapping hip and JHS/EDS-HT. He previously underwent surgery only to experience complete recurrence after one year. The patient followed a four month treatment program consisting of passive and assisted-active mobilization, joint stabilizing and proprioceptive enhancement exercises, and he was examined and evaluated before and after the program using clinical scales and a three-dimensional (3D) motion analysis system. The treatment led to improved scores on all clinical scales and pain assessment measures. Motion analysis showed more physiological spatio-temporal parameters and biomechanical pattern at the proximal joints during walking following treatment, while the ankle joints appeared more impaired in terms of the physiologic pattern. Our observations demonstrate the beneficial effects of rehabilitation in the mid-term management of snapping hip when it recurs after surgery in JHS/EDS-HT. These findings support the general concept of low efficacy of orthopedic surgery in JHS/EDS-HT and furthermore they highlight the benefits of physical therapy in the management of this syndrome in JHS/EDS-HT patients.