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Lookup NU author(s): Dr Richard Holleyman, Ajay MalviyaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2022, The Author(s). 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.
Author(s): Holleyman R, Sohatee MA, Lyman S, Malviya A, Khanduja V, Bankes MJK, Andrade T, Board T, Conroy J, Wilson M, McBryde C
Publication type: Article
Publication status: Published
Journal: Knee Surgery, Sports Traumatology, Arthroscopy
Year: 2023
Volume: 31
Pages: 58-69
Print publication date: 01/01/2023
Online publication date: 14/07/2022
Acceptance date: 09/06/2022
Date deposited: 12/08/2022
ISSN (print): 0942-2056
ISSN (electronic): 1433-7347
Publisher: Springer Nature
URL: https://doi.org/10.1007/s00167-022-07042-y
DOI: 10.1007/s00167-022-07042-y
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