Perspective from Dean K. Matsuda, MD
Source:

Palmer AJR, et al. BMJ. 2019;doi:10.1136/bmj.l185.

February 27, 2019
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Arthroscopic hip surgery yielded better outcomes vs physiotherapy and activity modification for FAI

Perspective from Dean K. Matsuda, MD
Source:

Palmer AJR, et al. BMJ. 2019;doi:10.1136/bmj.l185.

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Superior outcomes were seen in patients who underwent arthroscopic hip surgery for symptomatic femoroacetabular impingement compared with patients who were placed in physiotherapy and activity modification, according to a recently published study.

“Our multicenter, randomized controlled trial compared physiotherapy and activity modification with arthroscopic hip surgery for patients with femoroacetabular impingement syndrome,” Antony J. R. Palmer, MA, BMBCh, DPhil, FRCS (Tr & Orth), told Healio.com/Orthopedics. “Arthroscopic hip surgery proved superior at improving patient-reported symptoms 8 months after randomization. Arthroscopic hip surgery appears to be effective and safe, but further research is needed to identify which patients are most likely to benefit. Also, it is not known whether treatment offers sustained benefit with disease-modifying potential, which will be addressed with long-term follow-up of this cohort.”

Palmer and colleagues performed an assessor blinded, pragmatic, randomized controlled trial of patients with symptomatic FAI in which 100 patients were assigned to receive arthroscopic hip surgery and 88 patients were assigned to a program of physiotherapy and activity modification. Patients who received physiotherapy were given a goal-based program to improve core stability and movement control. Patients who received arthroscopic surgery underwent surgery to excise the bone that impinged during hip movements and then patients received routine postoperative care. The hip outcome score activities of daily living (HOS ADL) subscale at 8 months after randomization with a minimum clinically important difference between the intervention groups of nine points was the main outcome measure. Other outcomes included other patient-reported outcome measures and clinical assessment.

Results showed the mean HOS ADL was 78.4 points for patients who received arthroscopic hip surgery and was 69.2 points for patients who were assigned to the physiotherapy program. After the baseline HOS ADL, age, sex and study site were adjusted, the mean HOS ADL was 10 points higher in patients who underwent arthroscopic hip surgery compared with patients in the physiotherapy program group. There were no serious adverse events in either intervention group. – by Monica Jaramillo

 

Disclosures: Palmer reports he received funding from the Royal College of Surgeons of England and Dunhill Medical Trust. Please see the full study for a list of all other authors’ relevant financial disclosures.