TY - JOUR
T1 - Femoroacetabular impingement surgery leads to early pain relief but minimal functional gains past 6 months
T2 - experience from the FIRST trial
AU - on behalf of the FIRST Investigators
AU - Almasri, Mahmoud
AU - Simunovic, Nicole
AU - Heels-Ansdell, Diane
AU - Ayeni, Olufemi R.
AU - Ayeni, Olufemi R.
AU - Karlsson, Jon
AU - Thabane, Lehana
AU - Musahl, Volker
AU - Duong, Andrew
AU - Bhandari, Mohit
AU - Bedi, Asheesh
AU - Järvinen, Teppo
AU - Naudie, Douglas
AU - Seppänen, Matti
AU - Slobogean, Gerard
AU - Skelly, Matthew
AU - Shanmugaraj, Ajay
AU - Crouch, Sarah
AU - Sprague, Sheila
AU - Buckingham, Lisa
AU - Ramsay, Tim
AU - Lee, John
AU - Kousa, Petteri
AU - Carsen, Sasha
AU - Choudur, Hema
AU - Sim, Yan
AU - Johnston, Kelly
AU - Wong, Ivan
AU - Murphy, Ryland
AU - Sparavalo, Sara
AU - Whelan, Daniel
AU - Khan, Ryan
AU - Ca, Gavin
AU - Howells, Fiona
AU - Zomar, Bryn
AU - Pollock, Michael
AU - Willits, Kevin
AU - Firth, Andrew
AU - Wanlin, Stacey
AU - Remtulla, Alliya
AU - Kaniki, Nicole
AU - Belzile, Etienne L.
AU - Turmel, Sylvie
AU - Jørgensen, Uffe
AU - Gam-Pedersen, Annie
AU - Sihvonen, Raine
AU - Raivio, Marko
AU - Toivonen, Pirjo
AU - Routapohja, Mari Pirjetta
N1 - 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).
PY - 2021/5
Y1 - 2021/5
N2 - 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.
AB - 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.
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U2 - 10.1007/s00167-020-06401-x
DO - 10.1007/s00167-020-06401-x
M3 - Article
C2 - 33386426
AN - SCOPUS:85098525893
SN - 0942-2056
VL - 29
SP - 1362
EP - 1369
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
IS - 5
ER -