A X Realpe1, N E Foster2, E J Dickenson3,4, M Jepson5, D R Griffin3,4, J L Donovan5. 1. Population Health Sciences, University of Bristol, Canynge Hall 4.07, 39 Whatley Road, Bristol, BS8 2PS, UK. alba.realpe@bristol.ac.uk. 2. Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK. 3. University of Warwick, Coventry, UK. 4. University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK. 5. Population Health Sciences, University of Bristol, Canynge Hall 4.07, 39 Whatley Road, Bristol, BS8 2PS, UK.
Abstract
BACKGROUND: UK FASHIoN was a multicentre randomised controlled trial comparing hip arthroscopic surgery (HA) with personalised hip therapy (PHT, physiotherapist-led conservative care), for patients with hip pain attributed to femoroacetabular impingement (FAI) syndrome. Our aim was to describe the treatment and trial participation experiences of patients, to contextualise the trial results and offer further information to assist treatment decision-making in FAI. METHODS: We conducted in-depth semi-structured telephone interviews with a purposive sample of trial participants from each of the trial arms. They were interviewed after they received treatment and completed their first year of trial participation. Thematic analysis and constant comparison analytical approaches were used to identify themes of patient treatment experiences during the trial. RESULTS:Forty trial participants were interviewed in this qualitative study. Their baseline characteristics were similar to those in the main trial sample. On average, their hip-related quality of life (iHOT-33 scores) at 12 months follow-up were lower than average for all trial participants, indicating poorer hip-related quality of life as a consequence of theoretical sampling. Patient experiences occurred in five patient groups: those who felt their symptoms improved with hip arthroscopy, or with personal hip therapy, patients who felt their hip symptoms did not change with PHT but did not want HA, patients who decided to change from PHT to HA and a group who experienced serious complications after HA. Interviewees mostly described a trouble-free, enriching and altruistic trial participation experience, although most participants expected more clinical follow-up at the end of the trial. CONCLUSION: Both HA and PHT were experienced as beneficial by participants in the trial. Treatment success appeared to depend partly on patients' prior own expectations as well as their outcomes, and future research is needed to explore this further. Findings from this study can be combined with the primary results to inform future FAI patients. TRIAL REGISTRATION: Arthroscopic surgery for hip impingement versus best conventional care ( ISRCTN64081839 ). 28/02/2014.
RCT Entities:
BACKGROUND: UK FASHIoN was a multicentre randomised controlled trial comparing hip arthroscopic surgery (HA) with personalised hip therapy (PHT, physiotherapist-led conservative care), for patients with hip pain attributed to femoroacetabular impingement (FAI) syndrome. Our aim was to describe the treatment and trial participation experiences of patients, to contextualise the trial results and offer further information to assist treatment decision-making in FAI. METHODS: We conducted in-depth semi-structured telephone interviews with a purposive sample of trial participants from each of the trial arms. They were interviewed after they received treatment and completed their first year of trial participation. Thematic analysis and constant comparison analytical approaches were used to identify themes of patient treatment experiences during the trial. RESULTS: Forty trial participants were interviewed in this qualitative study. Their baseline characteristics were similar to those in the main trial sample. On average, their hip-related quality of life (iHOT-33 scores) at 12 months follow-up were lower than average for all trial participants, indicating poorer hip-related quality of life as a consequence of theoretical sampling. Patient experiences occurred in five patient groups: those who felt their symptoms improved with hip arthroscopy, or with personal hip therapy, patients who felt their hip symptoms did not change with PHT but did not want HA, patients who decided to change from PHT to HA and a group who experienced serious complications after HA. Interviewees mostly described a trouble-free, enriching and altruistic trial participation experience, although most participants expected more clinical follow-up at the end of the trial. CONCLUSION: Both HA and PHT were experienced as beneficial by participants in the trial. Treatment success appeared to depend partly on patients' prior own expectations as well as their outcomes, and future research is needed to explore this further. Findings from this study can be combined with the primary results to inform future FAI patients. TRIAL REGISTRATION: Arthroscopic surgery for hip impingement versus best conventional care ( ISRCTN64081839 ). 28/02/2014.
Entities:
Keywords:
Femoroacetabular impingement; Hip arthroscopy; Hip physiotherapy; Orthopaedic patient experiences; Qualitative study
Authors: Nicholas G H Mohtadi; Damian R Griffin; M Elizabeth Pedersen; Denise Chan; Marc R Safran; Nicholas Parsons; Jon K Sekiya; Bryan T Kelly; Jason R Werle; Michael Leunig; Joseph C McCarthy; Hal D Martin; J W Thomas Byrd; Marc J Philippon; Robroy L Martin; Carlos A Guanche; John C Clohisy; Thomas G Sampson; Mininder S Kocher; Christopher M Larson Journal: Arthroscopy Date: 2012-05 Impact factor: 4.772
Authors: D R Griffin; E J Dickenson; J O'Donnell; R Agricola; T Awan; M Beck; J C Clohisy; H P Dijkstra; E Falvey; M Gimpel; R S Hinman; P Hölmich; A Kassarjian; H D Martin; R Martin; R C Mather; M J Philippon; M P Reiman; A Takla; K Thorborg; S Walker; A Weir; K L Bennell Journal: Br J Sports Med Date: 2016-10 Impact factor: 13.800
Authors: D R Griffin; E J Dickenson; P D H Wall; J L Donovan; N E Foster; C E Hutchinson; N Parsons; S Petrou; A Realpe; J Achten; F Achana; A Adams; M L Costa; J Griffin; R Hobson; J Smith Journal: BMJ Open Date: 2016-08-31 Impact factor: 2.692
Authors: Peter Dh Wall; Edward J Dickenson; David Robinson; Ivor Hughes; Alba Realpe; Rachel Hobson; Damian R Griffin; Nadine E Foster Journal: Br J Sports Med Date: 2016-10 Impact factor: 13.800