Surgery for treating hip impingement (femoroacetabular impingement)
Information
- DOI:
- https://doi.org/10.1002/14651858.CD010796.pub2Copy DOI
- Database:
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- Cochrane Database of Systematic Reviews
- Version published:
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- 08 September 2014see what's new
- Type:
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- Intervention
- Stage:
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- Review
- Cochrane Editorial Group:
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Cochrane Musculoskeletal Group
- Copyright:
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- Copyright © 2014 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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Authors
Contributions of authors
PDH Wall designed the study, reviewed the abstracts and articles and drafted the review.
JS Brown contributed to the study design, reviewed the abstracts and articles and helped draft the review.
N Parsons is the review statistician and contributed to the study design and helped with data management and the analysis plan.
ML Costa contributed to the study design, and edited the protocol and final review.
R Buchbinder contributed to the study design and edited the protocol and final review.
DR Griffin designed the study, reviewed articles, and edited the protocol and final review. He is the guarantor of the review.
Sources of support
Internal sources
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No sources of support supplied
External sources
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National Institute for Health Research, UK.
NHR, Health Technology Assessment programme, (project number 10/41/02)
Declarations of interest
DR Griffin is the Chief Investigator, and PDH Wall and ML Costa are co‐Investigators, in UK FASHIoN, a UK NIHR HTA funded RCT of hip arthroscopy compared with best conventional care for FAI.
Acknowledgements
We would like to thank Tamara Rader, Cochrane Musculoskeletal Group, Ottawa, Ontario who has helped design and test the search strategy. We would also like to thank the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme (project number 10/41/02 and 13/103) who by virtue of an existing funded research project brought together many of the authors of this review.
Version history
| Published | Title | Stage | Authors | Version |
| 2014 Sep 08 | Surgery for treating hip impingement (femoroacetabular impingement) | Review | Peter DH Wall, Jamie S Brown, Nick Parsons, Rachelle Buchbinder, Matthew L Costa, Damian Griffin | |
| 2013 Nov 01 | Surgery for treating femoroacetabular impingement | Protocol | Peter DH Wall, Jamie S Brown, Nick Parsons, Rachelle Buchbinder, Matthew L Costa, Damian Griffin | |
Differences between protocol and review
1. As there were no published trials that fulfilled our criteria, we have:
a. described the Characteristics of ongoing studies, which included attempting to obtain further details from the named study contact or Chief Investigator;
b. summarised the evidence available from the Excluded studies.
2. We have removed the hierarchy for hip‐specific multidomain outcome measures described in the Secondary outcomes.
3. We have added a comparison of mixed‐type FAI to our proposed subgroup analysis of cam versus pincer‐type FAI.
4. We have edited some of the background text to provide more up to date information.
In accordance with latest Cochrane Musculoskeletal Group recommendations, we replaced the terms 'Primary outcomes' and 'Secondary outcomes' with the heading of 'Major outcomes'. 'Major outcomes' includes the seven most important outcomes that we intend to implement in the GRADE assessment and Summary of findings' tables in future versions of the review; we consider these outcomes are essential for decision‐masking.
Keywords
MeSH
Medical Subject Headings (MeSH) Keywords
Medical Subject Headings Check Words
Humans;
PRISMA flow diagram of search results.
Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. For more information, visit www.prisma‐statement.org/
| Study | No. of recruiting centres | Sample size | No. recruited to end of January 2014 | Type of surgery | Comparator | Primary outcome measure and time point post‐randomisation | Projected completion date |
| 1 | 140 | na | Arthroscopic surgery | Physiotherapy | HOS at 24 months | May 2014 | |
| 25 | 372 | 71 | Arthroscopic surgery | Physiotherapy | IHOT‐33 at 12 months | July 2017 | |
| 2 | 220 | 53 | Arthroscopic surgery | Sham surgery ‐ arthroscopic lavage of the hip joint with 3 litres of normal saline | Change in pain on a VAS at 6 months | June 2017 | |
| 2 | 120 | na | Arthroscopic surgery | Physiotherapy | HOS at 8 months | July 2017 | |
| na = not available Key to outcome measures: Hip Outcome Score (HOS) ‐ expressed as a score out of 100 (100 being the best outcome); International Hip Outcome Tool (IHOT‐33) ‐ expressed as a score out of 100 (100 being the best outcome); Visal Analogue Scale (VAS) for pain ‐ using a 10 cm line and expressed as a score out of 100 (0 being the best outcome). | |||||||
| Author | Type of study | Intervention 1 | Intervention 2 or Comparator | Unit of analysis and no. in each group | Outcome | AEs |
| Observational; comparative case series | 1. Open surgery: osteoplasty + labral resection | 2. Open surgery: osteoplasty + labral refixation | Hips 1. 25 2. 35 | Mean Merle d’Aubigné score (range) Pre‐operative 1. 12 (8‐13) 2. 12 (5‐16) 24 m post‐operative 1. 15 (10‐18) 2. 17 (13‐18) | None reported | |
| Observational; comparative case series | 1. Arthroscopic: osteoplasty | 2. Arthroscopic: debridement | Patients 1. 24 2. 47 | Median HHS (IQR) Pre‐operative 1. 59 (52‐64) 2. 55 (37‐72) 12 m post‐operative 1. 83 (75‐87) 2. 77 (59‐87) | None reported | |
| Observational; comparative case series | 1. Arthroscopic: osteoplasty+labral debridement | 2. Arthroscopic: osteoplasty + labral repair | Hips 1. 36 2. 39 | Mean MHHS 12m post op 1. 88 2. 94 | 1. Revision to THA=1 patient 2. Heterotopic ossification=3 patients 3. Revision osteoplasty=2 patients | |
| Observational; case series | 1. Arthroscopic: osteoplasty | None | Hips 1. 111 | Mean WOMAC score (SD) Pre‐operative 1. 60 (±14) Post‐operative at mean 10 m 1. 83 (±16) | 1. Revision to THA=5pts 2. Heterotropic ossification=3 patients 3. Neuropraxia=2 patients 4. Skin necrosis=1 patient | |
| Observational; comparative case series | 1. Arthroscopic: osteoplasty + labral repair | 2. Arthroscopic: osteoplasty + labral resection | Hips 1. 69 2. 32 | Mean MHHS (range) Pre‐operative 1. 60 (24‐85) 2. 62 (29‐96) Post‐operative at mean 29 m 1. 93 (55‐100) 2. 88 (35‐100) | None reported | |
| Observational; case series | 1. Open surgery: osteoplasty | None | Pts 1. 13 | Mean HHS (range) Pre‐operative 1. 63 (55‐70) Post‐operative 24 m 1. 89 (72‐98) | None reported | |
| Observational; case series | 1. Arthroscopic: osteoplasty | None | Patients 1. 612 | Mean Rosser Index Matrix‐created QoL score (range) Pre‐operative 1. 0.9 (‐1.4‐0.9) Post‐operative 12 m 1. 0.9 (0.7‐1) | None reported | |
| Observational; case series | 1. Arthroscopic: osteoplasty | None | Hips 1. 201 | Mean NAHS increased by 24 post‐operative at mean 46 m | None reported | |
| Observational; comparative case series | 1. Open surgery: osteoplasty | 2. Arthroscopic: osteoplasty | Patients 1. 10 2. 20 | Mean improvement in MHHS post‐operative at mean 24.8 m (range) 1. 22 (±12) 2. 24 (±11) | None reported | |
| Randomised trial comparing two different surgical interventions | 1. Arthroscopic: osteoplasty + labral repair | 2. Arthroscopic: osteoplasty + labral debridement | Patients 1. 18 2. 18 | Mean HOS‐ADL (range) Pre‐operative 1. 68 (26‐92) 2. 60 (23‐91) Post‐operative at mean 32 m 1. 91 (73‐100) 2. 80 (42‐100) | None reported | |
| Partly* randomised trial comparing two different surgical interventions | 1. Arthroscopic: osteoplasty | 2. Open surgery: osteoplasty | Patients 1. 23 2. 15 | Mean pain on a VAS at rest (SD) Pre‐operative 1. 15 (21) 2. 18 (13) 12 m post‐operative 1. 5 (12) 2. 15 (22) | None reported | |
| m = months, f/u = follow‐up, HHS = Harris Hip Score, IQR = interquartile range, SD = standard deviation, THA = total hip arthroplasty, * = 10 out of 38 patients included were randomised Key to outcome measures: Merle d’Aubigné ‐ expressed as a score out of 18 (18 being the best outcome); Harris Hip Score (HHS) ‐ expressed as a score out of 100 (100 being the best outcome); Modified Harris Hip Score (MHHS) ‐ expressed as a score out of 100 (100 being the best outcome); Harris Hip Score Acitivities of Daily Living (HOS‐ADL) ‐ expressed as a score out of 100 (100 being the best outcome); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) ‐ expressed as a score out of 100 (100 being the best outcome); Rosser Index Matrix‐created QoL ‐ expressed as a score from ‐1.486 to 1.000 (a score of 1.000 indicates normality and death is given a score of 0.000); Non Arthritic Hip Score (NAHS) ‐ expressed as a score out of 100 (100 being the best outcome); Visual Analogue Scale (VAS) at rest for pain ‐ expressed as a score out of 100 (0 being no pain). | ||||||
