Richard Holleyman1, Mark Andrew Sohatee2, Stephen Lyman3, Ajay Malviya2, Vikas Khanduja4. 1. Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England. 2. Northumbria NHS Foundation Trust, Newcastle upon Tyne, England. 3. The Hospital for Special Surgery, New York, NY, USA. 4. Addenbrooke's - Cambridge University Hospitals NHS Foundation Trust, Cambridge, England. vk279@cam.ac.uk.
Abstract
PURPOSE: Results from recent randomised controlled trials demonstrate the superiority of surgery over physiotherapy in patients with femoroacetabular impingement (FAI) of the hip in early follow-up. However, there is paucity of evidence regarding which factors influence outcomes of FAI surgery, particularly notable is the lack of information on the effect of impingement subtype (cam or pincer or mixed) on patient reported outcomes measures (PROMs). This study aims to evaluate the early outcomes of hip arthroscopy for FAI, and their determinants. METHODS: This is a retrospective analysis of prospectively collected data from the UK Non-Arthroplasty Hip Registry (NAHR) of patients undergoing arthroscopic intervention for FAI between 2012 and 2019. The null hypothesis was that there is no difference in PROMs, based on morphological subtype of FAI treated or patient characteristics, at each follow-up timepoint. The outcome measures used for the study were the iHOT-12 score and the EQ5D Index and VAS 6- and 12-month follow-up. RESULTS: A cohort of 4963 patients who underwent arthroscopic treatment of FAI were identified on the NAHR database. For all FAI pathology groups, there was significant improvement from pre-operative PROMs when compared to those at 6 and 12 months. Overall, two-thirds of patients achieved the minimum clinically important difference (MCID), and almost half achieved substantial clinical benefit (SCB) for iHOT-12 by 12 months. Pre-operatively, and at 12-month follow-up, iHOT-12 scores were significantly poorer in the pincer group compared to the cam and mixed pathology groups (p < 0.01). Multivariable analysis revealed PROMS improvement in the setting of a higher-grade cartilage lesion. CONCLUSION: This registry study demonstrates that hip arthroscopy is an effective surgical treatment for patients with symptomatic FAI and results in a statistically significant improvement in PROMs which are maintained through 12 months follow-up. LEVEL OF EVIDENCE: III.
PURPOSE: Results from recent randomised controlled trials demonstrate the superiority of surgery over physiotherapy in patients with femoroacetabular impingement (FAI) of the hip in early follow-up. However, there is paucity of evidence regarding which factors influence outcomes of FAI surgery, particularly notable is the lack of information on the effect of impingement subtype (cam or pincer or mixed) on patient reported outcomes measures (PROMs). This study aims to evaluate the early outcomes of hip arthroscopy for FAI, and their determinants. METHODS: This is a retrospective analysis of prospectively collected data from the UK Non-Arthroplasty Hip Registry (NAHR) of patients undergoing arthroscopic intervention for FAI between 2012 and 2019. The null hypothesis was that there is no difference in PROMs, based on morphological subtype of FAI treated or patient characteristics, at each follow-up timepoint. The outcome measures used for the study were the iHOT-12 score and the EQ5D Index and VAS 6- and 12-month follow-up. RESULTS: A cohort of 4963 patients who underwent arthroscopic treatment of FAI were identified on the NAHR database. For all FAI pathology groups, there was significant improvement from pre-operative PROMs when compared to those at 6 and 12 months. Overall, two-thirds of patients achieved the minimum clinically important difference (MCID), and almost half achieved substantial clinical benefit (SCB) for iHOT-12 by 12 months. Pre-operatively, and at 12-month follow-up, iHOT-12 scores were significantly poorer in the pincer group compared to the cam and mixed pathology groups (p < 0.01). Multivariable analysis revealed PROMS improvement in the setting of a higher-grade cartilage lesion. CONCLUSION: This registry study demonstrates that hip arthroscopy is an effective surgical treatment for patients with symptomatic FAI and results in a statistically significant improvement in PROMs which are maintained through 12 months follow-up. LEVEL OF EVIDENCE: III.
Authors: Fernando Comba; Carlos Yacuzzi; Pablo J Ali; Gerardo Zanotti; Martin Buttaro; Francisco Piccaluga Journal: Muscles Ligaments Tendons J Date: 2016-12-21
Authors: Rachel M Frank; Simon Lee; Charles A Bush-Joseph; Michael J Salata; Richard C Mather; Shane J Nho Journal: J Bone Joint Surg Am Date: 2016-05-18 Impact factor: 5.284
Authors: Gregory L Cvetanovich; Alexander E Weber; Benjamin D Kuhns; Jennifer Alter; Joshua D Harris; Richard C Mather; Shane J Nho Journal: Am J Sports Med Date: 2017-11-21 Impact factor: 6.202
Authors: Benjamin G Domb; Timothy J Martin; Chengcheng Gui; Sivashankar Chandrasekaran; Carlos Suarez-Ahedo; Parth Lodhia Journal: Am J Sports Med Date: 2018-03-23 Impact factor: 6.202
Authors: Brian M Capogna; Michael K Ryan; John P Begly; Kristofer E Chenard; Siddharth A Mahure; Thomas Youm Journal: Arthroscopy Date: 2016-08-17 Impact factor: 4.772