A multi-centre randomized controlled trial comparing arthroscopic osteochondroplasty and lavage with arthroscopic lavage alone on patient important outcomes and quality of life in the treatment of young adult (18-50) Femoroacetabular impingement

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Ayeni , O R , Simunovic , N , Crouch , S , Grassby , M H-S , Hoyeck , P , Islam , Z , Wood , G , Jorgensen , U , Seppanen , M , Junnila , M , Virolainen , P , Routapohja , M , Sihvonen , R , Raivio , M , Toivonen , P , Joukainen , A , Kaariainen , T , Jalava , E , Jarvinen , T & FIRST Investigators 2015 , ' A multi-centre randomized controlled trial comparing arthroscopic osteochondroplasty and lavage with arthroscopic lavage alone on patient important outcomes and quality of life in the treatment of young adult (18-50) Femoroacetabular impingement ' , BMC Musculoskeletal Disorders , vol. 16 , 64 . https://doi.org/10.1186/s12891-015-0500-y

Title: A multi-centre randomized controlled trial comparing arthroscopic osteochondroplasty and lavage with arthroscopic lavage alone on patient important outcomes and quality of life in the treatment of young adult (18-50) Femoroacetabular impingement
Author: Ayeni, Olufemi R.; Simunovic, Nicole; Crouch, Sarah; Grassby, Maggie Hamel-Smith; Hoyeck, Patricia; Islam, Zakia; Wood, Gavin; Jorgensen, Uffe; Seppanen, Matti; Junnila, Mika; Virolainen, Petri; Routapohja, Mari; Sihvonen, Raine; Raivio, Marko; Toivonen, Pirjo; Joukainen, Antti; Kaariainen, Tommi; Jalava, Elina; Jarvinen, Teppo; FIRST Investigators
Contributor: University of Helsinki, Clinicum
Date: 2015-03-20
Language: eng
Number of pages: 12
Belongs to series: BMC Musculoskeletal Disorders
ISSN: 1471-2474
URI: http://hdl.handle.net/10138/164129
Abstract: Background: Several cross-sectional studies have estimated that the prevalence of femoroacetabular impingement (FAI) ranges from 14-17% among asymptomatic young adults to almost 95% among competitive athletes. With FAI, there is abnormal contact between the proximal femur and the acetabulum, resulting in abnormal mechanics with terminal motion such as hip flexion and rotation. This condition results from bony anomalies of the acetabular rim (Pincer) and or femoral head/neck junction (CAM) and typically causes hip pain and decreased hip function. The development of hip pain potentially serves as an indicator for early cartilage and labral damage that may result in hip osteoarthritis. Although surgical correction of the misshaped bony anatomy and associated intra-articular soft tissue damage of the hip is thought to improve hip pain and alter the natural history of degenerative disease, the supportive evidence is based upon low quality observational studies. The Femoroacetabular Impingement RandomiSed controlled Trial (FIRST) compares outcomes following surgical correction of the impingement morphology (arthroscopic osteochondroplasty) with/without labral repair versus arthroscopic lavage of the hip joint in adults aged 18 to 50 diagnosed with FAI. Methods and design: FIRST is a multi-centre, randomized controlled trial with a sample size of 220 patients. Exclusion criteria include the presence of hip syndromes, previous surgery or trauma to the affected hip, and significant medical comorbidities. The primary outcome is pain and the secondary outcomes include patient function, quality of life, complications, and cost-effectiveness - all within one year of follow-up. Patients are stratified based on centre and impingement sub-type. Patients, outcome assessors, data analysts, and the Steering Committee are blinded to surgical allocation. Using an intention-to-treat approach, outcome analyses will be performed using an analysis of covariance and descriptive statistics. Discussion: Symptomatic FAI is associated with chronic hip pain, functional limitations, and secondary osteoarthritis. Therefore, optimizing treatment has the potential to improve the lives millions of young, active persons who are diagnosed with this condition. Few orthopaedic surgical trials have similar potential to shift the paradigm of care dramatically towards (or away) from surgical bony and soft tissue interventions.
Subject: Femoroacetabular impingement
Arthroplasty
Osteochondroplasty
Lavage
Randomized controlled trial
Protocol
FORM HEALTH SURVEY
HIP ARTHROSCOPY
CAM IMPINGEMENT
SURGICAL INDICATIONS
INTERNATIONAL INDEX
ERECTILE FUNCTION
SEXUAL FUNCTION
PAIN INTENSITY
EUROQOL EQ-5D
ALPHA ANGLE
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
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