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Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients
Hip arthroscopy (HA) is an established treatment option to address intra-articular pathology of the hip. However, some clinicians encourage non-operative management (NOM). Non-operative management may include active measures such as physiotherapy and intra-articular steroid injections, or NOM may in...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467427/ https://www.ncbi.nlm.nih.gov/pubmed/28630719 http://dx.doi.org/10.1093/jhps/hnw051 |
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author | Spencer-Gardner, Luke Dissanayake, Ruch Kalanie, Amir Singh, Parminder O’Donnell, John |
author_facet | Spencer-Gardner, Luke Dissanayake, Ruch Kalanie, Amir Singh, Parminder O’Donnell, John |
author_sort | Spencer-Gardner, Luke |
collection | PubMed |
description | Hip arthroscopy (HA) is an established treatment option to address intra-articular pathology of the hip. However, some clinicians encourage non-operative management (NOM). Non-operative management may include active measures such as physiotherapy and intra-articular steroid injections, or NOM may involve so called watchful waiting with no active intervention. These approaches, along with surgery have been detailed recently in the Warwick Agreement, a Consensus Statement regarding diagnosis and treatment of Femoroacetabular Impingement Syndrome The aim of this study is to compare the change in clinical outcome scores of waitlisted patients with intra-articular hip pathology who receive no active treatment with matched controls that have undergone HA. Patients less than 60 years of age were identified from a HA waiting list in a single hospital in the Australian public hospital system. Patient reported outcomes (PRO) were collected whilst patients waited for surgery. During this waiting period no specific treatment was offered. A separate group of patients who had previously undergone HA were matched based on age, sex, body mass index and baseline non-arthritic hip scores (NAHS). The groups were compared using the NAHS as the primary outcome measures. Modified Harris Hip Scores were also collected and compared. Thirty-six patients were included in each group, with a mean follow up of 19 months (12–36). There were no significant differences in age, sex, BMI and NAHS between groups at baseline. At final follow up, mean NAHS scores after HA were significantly higher than scores after NOM, 82.1 (36.4–100.0) versus 48.9 (11.3–78.8), respectively (P < 0.001) with a large effect size for mean change in scores between groups (d = 1.77, 95% CI 1.21–2.30). Mean mHHS after HA were significantly higher than scores after NOM, 84.3 (15.4–100.0) versus 48.1 (21.0–66.0) respectively (P < 0.001), with a large effect size for mean change in scores between groups (d = 1.92, 95% CI 1.34–2.46). HA may lead to significant improvements in PRO when compared to non-operative management of waitlisted patients with intra-articular pathology of the hip at 18 months follow-up. |
format | Online Article Text |
id | pubmed-5467427 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-54674272017-06-19 Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients Spencer-Gardner, Luke Dissanayake, Ruch Kalanie, Amir Singh, Parminder O’Donnell, John J Hip Preserv Surg Research Articles Hip arthroscopy (HA) is an established treatment option to address intra-articular pathology of the hip. However, some clinicians encourage non-operative management (NOM). Non-operative management may include active measures such as physiotherapy and intra-articular steroid injections, or NOM may involve so called watchful waiting with no active intervention. These approaches, along with surgery have been detailed recently in the Warwick Agreement, a Consensus Statement regarding diagnosis and treatment of Femoroacetabular Impingement Syndrome The aim of this study is to compare the change in clinical outcome scores of waitlisted patients with intra-articular hip pathology who receive no active treatment with matched controls that have undergone HA. Patients less than 60 years of age were identified from a HA waiting list in a single hospital in the Australian public hospital system. Patient reported outcomes (PRO) were collected whilst patients waited for surgery. During this waiting period no specific treatment was offered. A separate group of patients who had previously undergone HA were matched based on age, sex, body mass index and baseline non-arthritic hip scores (NAHS). The groups were compared using the NAHS as the primary outcome measures. Modified Harris Hip Scores were also collected and compared. Thirty-six patients were included in each group, with a mean follow up of 19 months (12–36). There were no significant differences in age, sex, BMI and NAHS between groups at baseline. At final follow up, mean NAHS scores after HA were significantly higher than scores after NOM, 82.1 (36.4–100.0) versus 48.9 (11.3–78.8), respectively (P < 0.001) with a large effect size for mean change in scores between groups (d = 1.77, 95% CI 1.21–2.30). Mean mHHS after HA were significantly higher than scores after NOM, 84.3 (15.4–100.0) versus 48.1 (21.0–66.0) respectively (P < 0.001), with a large effect size for mean change in scores between groups (d = 1.92, 95% CI 1.34–2.46). HA may lead to significant improvements in PRO when compared to non-operative management of waitlisted patients with intra-articular pathology of the hip at 18 months follow-up. Oxford University Press 2017-01-10 /pmc/articles/PMC5467427/ /pubmed/28630719 http://dx.doi.org/10.1093/jhps/hnw051 Text en © The Author 2017. Published by Oxford University Press http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Research Articles Spencer-Gardner, Luke Dissanayake, Ruch Kalanie, Amir Singh, Parminder O’Donnell, John Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
title | Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
title_full | Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
title_fullStr | Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
title_full_unstemmed | Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
title_short | Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
title_sort | hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467427/ https://www.ncbi.nlm.nih.gov/pubmed/28630719 http://dx.doi.org/10.1093/jhps/hnw051 |
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