Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients.

Published on Jan 10, 2017in Journal of Hip Preservation Surgery1.872
· DOI :10.1093/JHPS/HNW051
Luke Spencer-Gardner1
Estimated H-index: 1
(Baylor University Medical Center),
Ruch Dissanayake1
Estimated H-index: 1
+ 2 AuthorsJohn O'Donnell16
Estimated H-index: 16
Sources
Abstract
: Hip arthroscopy (HA) is an established treatment option to address intra-articular pathology of the hip. However, some clinicians encourage non-operative management (NOM). Non-operative management may include active measures such as physiotherapy and intra-articular steroid injections, or NOM may involve so called watchful waiting with no active intervention. These approaches, along with surgery have been detailed recently in the Warwick Agreement, a Consensus Statement regarding diagnosis and treatment of Femoroacetabular Impingement Syndrome The aim of this study is to compare the change in clinical outcome scores of waitlisted patients with intra-articular hip pathology who receive no active treatment with matched controls that have undergone HA. Patients less than 60 years of age were identified from a HA waiting list in a single hospital in the Australian public hospital system. Patient reported outcomes (PRO) were collected whilst patients waited for surgery. During this waiting period no specific treatment was offered. A separate group of patients who had previously undergone HA were matched based on age, sex, body mass index and baseline non-arthritic hip scores (NAHS). The groups were compared using the NAHS as the primary outcome measures. Modified Harris Hip Scores were also collected and compared. Thirty-six patients were included in each group, with a mean follow up of 19 months (12-36). There were no significant differences in age, sex, BMI and NAHS between groups at baseline. At final follow up, mean NAHS scores after HA were significantly higher than scores after NOM, 82.1 (36.4-100.0) versus 48.9 (11.3-78.8), respectively (P < 0.001) with a large effect size for mean change in scores between groups (d = 1.77, 95% CI 1.21-2.30). Mean mHHS after HA were significantly higher than scores after NOM, 84.3 (15.4-100.0) versus 48.1 (21.0-66.0) respectively (P < 0.001), with a large effect size for mean change in scores between groups (d = 1.92, 95% CI 1.34-2.46). HA may lead to significant improvements in PRO when compared to non-operative management of waitlisted patients with intra-articular pathology of the hip at 18 months follow-up.
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References36
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#2Nolan S. Horner (McMaster University)H-Index: 15
Last. Olufemi R. Ayeni (McMaster University)H-Index: 53
view all 9 authors...
Purpose Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods.
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The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentation...
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#1Alexis A. Wright (High Point University)H-Index: 20
#2Eric J. Hegedus (High Point University)H-Index: 27
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Abstract Objectives To determine the efficacy of physical therapy on pain and physical function in patients with femoroacetabular impingement. Design Randomized, participant- and assessor blinded controlled trial pilot study. Methods This trial was registered at ClinicalTrials.gov (NCT01814124) and reported according to Consolidated Standards of Reporting Trials (CONSORT) requirements. Patients were randomly assigned to receive either a combination of manual therapy and supervised exercise (MTEX...
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#1Gregory L. Cvetanovich (Rush Medical College)H-Index: 31
#2Alexander E. Weber (Rush Medical College)H-Index: 23
Last. Shane J. Nho (Rush Medical College)H-Index: 66
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The objective of this study was to determine if adolescent and young adult patients undergoing hip arthroscopy for symptomatic femoroacetabular impingement (FAI) experience clinically meaningful improvements in functional outcome scores. A consecutive series of patients under age 18 who underwent primary hip arthroscopy for symptomatic FAI was identified using our institution’s hip registry. Demographics, preoperative radiographic measurements, and preoperative and postoperative patient-reported...
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#1Damian R. Griffin (Warw.: University of Warwick)H-Index: 32
#2Peter Wall (Warw.: University of Warwick)H-Index: 24
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Background Femoroacetabular impingement (FAI) is a syndrome of hip or groin pain associated with shape abnormalities of the hip joint. Treatments include arthroscopic surgery and conservative care. This study explored the feasibility of a randomised controlled trial to compare these treatments. Objectives The objectives of this study were to estimate the number of patients available for a full randomised controlled trial (RCT); to explore clinician and patient willingness to participate in such ...
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#1Benedict U. Nwachukwu (HSS: Hospital for Special Surgery)H-Index: 38
#2Brian J. Rebolledo (HSS: Hospital for Special Surgery)H-Index: 14
Last. Bryan T. Kelly (HSS: Hospital for Special Surgery)H-Index: 81
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#1Robert Stein (UCL: University College London)H-Index: 45
#2Janet A. Dunn (University Hospitals Coventry and Warwickshire NHS Trust)H-Index: 60
Last. Andreas Makris (Mount Vernon Hospital)H-Index: 39
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There is uncertainty about the chemotherapy sensitivity of some oestrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancers. Multiparameter assays that measure the expression of several tumour genes simultaneously have been developed to guide the use of adjuvant chemotherapy for this breast cancer subtype. The assays provide prognostic information and have been claimed to predict chemotherapy sensitivity. There is a dearth of prospective validation s...
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#1Nancy Mansell (American Physical Therapy Association)H-Index: 2
#2Daniel I. RhonH-Index: 16
Last. John Meyer (SC: University of Southern California)H-Index: 2
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As the prevalence of hip pathology in the younger athletic population rises, the medical community continues to investigate effective intervention options. Femoracetabular impingement is the morphologically abnormal articulation of the femoral head against the acetabulum, and often implicated in pre-arthritic hip conditions of musculoskeletal nature. Arthroscopic surgical decompression and non-surgical rehabilitation programs focused on strengthening and stability are common interventions. Howev...
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Last. Asheesh Bedi (UM: University of Michigan)H-Index: 76
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Purpose To provide a comprehensive review and summary of the research published in Arthroscopy: The Journal of Arthroscopic and Related Surgery and The American Journal of Sports Medicine ( AJSM ) related to hip arthroscopy for femoroacetabular impingement (FAI). Methods A comprehensive review was conducted in duplicate of Arthroscopy and AJSM from February 2012 to February 2015 for all articles related to FAI, and a quality assessment was completed for all included studies. Clinical outcomes we...
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Femoroacetabuler impingement (FAI) is becoming increasingly recognised as a potential pathological entity for individuals with hip pain. Surgery described to correct FAI has risen exponentially in the past 10 years with the use of hip arthroscopy. Unfortunately, the strength of evidence supporting both the examination and treatment of FAI does not appear to accommodate this exponential growth. In fact, the direction currently taken for FAI is similar to previously described paths of other orthop...
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Background:Bony morphology is central to the pathomechanism of femoroacetabular impingement syndrome (FAIS), however isolated radiographic measures poorly predict symptom onset and severity. More c...
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#1Ida Lindman (University of Gothenburg)H-Index: 3
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PURPOSE The aim of this systematic review was to evaluate the trends in the literature regarding surgical treatment for femoroacetabular impingement syndrome (FAIS) and to present which patient-reported outcome-measures (PROMs) and surgical approaches are included. METHODS This systematic review was conducted with the PRISMA guidelines. The literature search was performed on PubMed and Embase, covering studies from 1999 to 2020. Inclusion criteria were clinical studies with surgical treatment fo...
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#1Manish P. Mehta (Columbia University)H-Index: 1
Last. T. Sean LynchH-Index: 21
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INTRODUCTION Hip arthroscopy is an increasingly used surgical procedure for both intra- and extra-articular hip pathologies, including femoroacetabular impingement (FAI). Although the arthroscopic approach is known to be preferable to open, the optimal timing of such intervention is unclear. The purpose of this study was to carry out an expected value decision analysis of immediate versus delayed hip arthroscopy for FAI. Its hypothesis is immediate hip arthroscopy is the preferable treatment opt...
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#1Benjamin G. DombH-Index: 60
#2Sarah L. ChenH-Index: 6
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#2Federico Yanez‐Siller (U of T: University of Toronto)H-Index: 1
Last. Tim Dwyer (U of T: University of Toronto)H-Index: 28
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RATIONALE AND OBJECTIVES: To analyse the referral pattern for hip pain and to investigate the wait time for an orthopaedic assessment by a hip arthroscopy surgeon in a single payer health care system. We hypothesized that a significant delay from time of onset of symptoms to time of assessment by a hip arthroscopy surgeon exists. METHOD: Retrospective review of prospectively collected data in an academic hospital in a single payer health care system. An electronic database analysis was conducted...
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#1Olawale A Sogbein (Northern Ontario School of Medicine)H-Index: 3
#2Ajay Shah (McMaster University)H-Index: 6
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Background:The benefits of hip arthroscopic surgery in the setting of femoroacetabular impingement (FAI) have been well established; however, some patients may experience a greater degree of improv...
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Background Femoro-acetabular impingement (FAI) is known as a predisposing factor in the development of osteoarthritis of the hip. In order to treat this condition, hip arthroscopy is considered as the gold standard in recent years. The number of performed hip arthroscopies has risen immensely. However, a number of patients with poor outcome after hip arthroscopy will require further surgical intervention, sometimes even conversion into THR (total hip replacement). The purpose of this study was t...
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#1Ryan P. McGovern (RMIT: RMIT University)H-Index: 6
#2RobRoy L. Martin (RMIT: RMIT University)H-Index: 40
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Background: Non-arthritic hip pain is defined as being related to pathologies of the intra-articular structures of the hip that can be symptomatic. A trial of non-operative management is commonly recommended before consideration of surgery for individuals with non-arthritic hip conditions. There is a need to describe a non-operative or conservative treatment plan for individuals with non-arthritic hip pain. Purpose: The purpose of this literature review was to systematically examine the literatu...
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#1Rima Nasser (University Medical Center Rizk Hospital)H-Index: 4
#2Benjamin G. DombH-Index: 60
The purpose of this article is to give a general overview of femoroacetabular impingement (FAI) and how it could be treated arthroscopically, with some details about indications, the procedure itse...
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#1Alastair G. Dick (Guy's and St Thomas' NHS Foundation Trust)H-Index: 5
Last. Marcus J.K. Bankes (Guy's and St Thomas' NHS Foundation Trust)H-Index: 6
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### What you need to know Hip pain in young adults is not normal and can be severe and disabling, affecting work, parenting, and leisure activities.12 The causes of hip pain in young adults (aged 16-50) tend to receive less attention than those in children (including Perthes’ disease, slipped capital femoral epiphysis, and septic arthritis) and in older patients (usually osteoarthritis). Imaging studies might not reveal an underlying problem, even where the patient’s symptoms are a consequence o...
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