Lindsey Brown1, Marcie Harris-Hayes2, Randi Foraker3, Kathryn Glaws4, W Kelton Vasileff5, Stephanie Di Stasi6. 1. PhD Candidate, Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University & Graduate Research Associate, Sports Medicine Research Institute, The Ohio State University, Wexner Medical Center, Columbus, OH, USA. 2. Associate Professor, Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA. 3. Associate Professor, Institute for Informatics, Washington University School of Medicine, St. Louis, MO, USA. 4. Physical Therapist, Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 5. Orthopaedic Surgeon, Sports Medicine Research Institute, The Ohio State University Wexner Medical Center & Assistant Professor, Department of Orthopaedics, The Ohio State University, Columbus, OH, USA. 6. Assistant Professor, Division of Physical Therapy, School of Health and Rehabilitation Sciences; Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University & Research Scientist, Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Abstract
BACKGROUND: Non-arthritic hip disease (NAHD) is a clinical condition often accompanied by painful movement. Current literature is lacking regarding how movement abnormalities are evaluated and treated in this population, which may be key to identifying which patients may respond to non-operative versus operative treatment. Combining the expertise of a hip arthroscopist and physical therapist may better inform treatment decisions for persons with NAHD. The primary objective of this study is to identify the extent to which an interdisciplinary evaluation between a physical therapist and surgeon influences treatment decisions of persons presenting to a hip preservation clinic. RATIONALE FOR STUDY DESIGN: A prospective, randomized controlled trial provides the ability to identify cause and effect of this new evaluation type. METHODS: Ninety-six adults with unilateral, NAHD presenting to a hip preservation clinic for initial evaluation will be randomized to receive either a standard evaluation with a surgeon or an interdisciplinary evaluation by a physical therapist and surgeon. Regardless of group, the surgeon conducts a standard-care examination. For participants in the interdisciplinary group, the physical therapist conducts an assessment of 6 postures and movements to identify asymmetrical, abnormal, or painful strategies. Treatment selection(s) and decisional conflict will be compared between groups after the evaluations. DISCUSSION: Persons with NAHD may experience considerable decisional conflict because of prolonged duration of symptoms and minimal evidence to compare operative and non-operative treatment for this population. The findings of this study have the potential to improve patient experience and produce more informed and supported treatment decisions for persons considering surgical treatment for NAHD.
BACKGROUND: Non-arthritic hip disease (NAHD) is a clinical condition often accompanied by painful movement. Current literature is lacking regarding how movement abnormalities are evaluated and treated in this population, which may be key to identifying which patients may respond to non-operative versus operative treatment. Combining the expertise of a hip arthroscopist and physical therapist may better inform treatment decisions for persons with NAHD. The primary objective of this study is to identify the extent to which an interdisciplinary evaluation between a physical therapist and surgeon influences treatment decisions of persons presenting to a hip preservation clinic. RATIONALE FOR STUDY DESIGN: A prospective, randomized controlled trial provides the ability to identify cause and effect of this new evaluation type. METHODS: Ninety-six adults with unilateral, NAHD presenting to a hip preservation clinic for initial evaluation will be randomized to receive either a standard evaluation with a surgeon or an interdisciplinary evaluation by a physical therapist and surgeon. Regardless of group, the surgeon conducts a standard-care examination. For participants in the interdisciplinary group, the physical therapist conducts an assessment of 6 postures and movements to identify asymmetrical, abnormal, or painful strategies. Treatment selection(s) and decisional conflict will be compared between groups after the evaluations. DISCUSSION: Persons with NAHD may experience considerable decisional conflict because of prolonged duration of symptoms and minimal evidence to compare operative and non-operative treatment for this population. The findings of this study have the potential to improve patient experience and produce more informed and supported treatment decisions for persons considering surgical treatment for NAHD.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: John C Clohisy; Evan R Knaus; Devyani M Hunt; John M Lesher; Marcie Harris-Hayes; Heidi Prather Journal: Clin Orthop Relat Res Date: 2009-01-07 Impact factor: 4.176