Femoroacetabular impingement surgery leads to early pain relief but minimal functional gains past 6 months: experience from the FIRST trial

on behalf of the FIRST Investigators

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13 Citas (Scopus)

Resumen

Purpose: To understand the early outcomes after hip arthroscopy and better define the trajectory of improvement in a prospective cohort of patients who have undergone hip arthroscopic osteochondroplasty for femoroacetabular impingement (FAI) syndrome. Methods: Data were analyzed from the Femoroacetabular Impingement RandomiSed controlled Trial (FIRST) on the 108 study patients who underwent osteochondroplasty, with or without labral repair. Study outcomes included patient-reported pain (using a 100-point Visual Analogue Scale (VAS)), hip function (using the Hip Outcome Score (HOS) and International Hip Outcome Tool (iHOT-12)), and health-related quality of life (using the EuroQol 5 Dimensions (EQ-5D)) measured at baseline, 2 weeks, 3 months, 6 months, and 12 months post-operatively. Results: There was a decrease in mean post-operative pain VAS scores from baseline. The first 2 weeks post-operative yielded the greatest reduction in pain with a mean (SD) VAS score of 37.8 (23.4), with score stabilization between 6 months (26.9 (26.9)) and 12 months (25.3 (27.6)). Mean HOS (activities of daily living) scores improved from baseline (59.7 (16.2)) starting at 6 weeks post-operative (64.1 (19.1)). The HOS (Sports) showed no improvement from baseline (41.2 (20.4)) until 3 months (49.1 (27.9)), and continued to improve at 6 months (64.1 (28.7)) and 12 months (68.6 (30.5)). The iHOT-12 scores showed functional improvement from baseline (31.3 (18.8)), as early as 6 weeks (44.9 (22.4)) up to and including 12 months (67.1 (29.7)). EQ-5D index scores showed modest steady improvement from 6 weeks to 12 months post-operative, while the EQ-5D VAS component similarly showed modest and steady improvements from 3 months onward. Conclusion: Results from this study highlight that hip arthroscopic osteochondroplasty with or without labral repair for FAI leads to early pain relief. While all scores improved from baseline, functional gains appear to plateau from 6 months onwards. These data can be used to inform decision-making about timelines for rehabilitation and return to sport, a knowledge gap in the current FAI literature. Level of evidence: II.

Idioma originalEnglish
Páginas (desde-hasta)1362-1369
Número de páginas8
PublicaciónKnee Surgery, Sports Traumatology, Arthroscopy
Volumen29
N.º5
DOI
EstadoPublished - may. 2021

Nota bibliográfica

Funding Information:
Research grants for the FIRST trial were received from the Canadian Institutes of Health Research (CIHR) (PI: ORA, MB), American Orthopaedic Society for Sports Medicine (PI: ORA), Canadian Orthopaedic Foundation (PI: ORA, MB), McMaster Surgical Associates (PI: ORA, MB), and Hamilton Health Sciences Department of Surgery (PI: ORA).

Publisher Copyright:
© 2021, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

ASJC Scopus Subject Areas

  • Surgery
  • Orthopedics and Sports Medicine

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial

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