The Horsens-Aarhus Femoro Acetabular Impingement (HAFAI) cohort: outcome of arthroscopic treatment for femoroacetabular impingement. Protocol for a prospective cohort study

Signe Kierkegaard, Bent Lund, Ulrik Dalgas, Henrik Sørensen, Kjeld Søballe, Inger Mechlenburg, Signe Kierkegaard, Bent Lund, Ulrik Dalgas, Henrik Sørensen, Kjeld Søballe, Inger Mechlenburg

Abstract

Introduction: During the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated.

Methods and analysis: In this prospective cohort study, a total of 60 patients with FAI scheduled for arthroscopic surgery will be followed and tested preoperatively, and again after 3, 6, 9 and 12 months. Assessment includes isokinetic dynamometry evaluating hip flexion and extension; evaluation of functional capacity in a three-dimensional motion laboratory; pain assessment; self-reported function, quality of life, expectation and satisfaction with the surgery; recording of previous and present sporting activities and accelerometry. In addition, data on surgical procedure, rehabilitation progress, adverse events and failure will be recorded. Patients will be compared with an age-matched and gender-matched reference group of 30 persons with no hip, knee, ankle or back problems. Long-term follow-up of this cohort may evaluate possible reoperations and development of hip osteoarthritis. Furthermore, analysis on how subgroups respond to the treatment could be performed together with identification of possible "non-responders".

Ethics and dissemination: The study is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-239-14). The results from this study will be presented at national and international congresses and published in peer-reviewed journals.

Trial registration number: NCT02306525.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Figures

Figure 1
Figure 1
Study design.

References

    1. Agricola R, Waarsing JH, Arden NK et al. . Cam impingement of the hip—a risk factor for hip osteoarthritis. Nat Rev Rheumatol 2013;9:630–4. 10.1038/nrrheum.2013.114
    1. Beck M, Kalhor M, Leunig M et al. . Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br 2005;87:1012–18. 10.1302/0301-620X.87B7.15203
    1. Crawford JR, Villar RN. Current concepts in the management of femoroacetabular impingement. J Bone Joint Surg Br 2005;87:1459–62. 10.1302/0301-620X.87B11.16821
    1. Frank JM, Harris JD, Erickson BJ et al. . Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: a systematic review. Arthroscopy 2015;31:1199–204. 10.1016/j.arthro.2014.11.042
    1. Agricola R, Bessems JH, Ginai AZ et al. . The development of Cam-type deformity in adolescent and young male soccer players. Am J Sports Med 2012;40:1099–106. 10.1177/0363546512438381
    1. Ganz R, Parvizi J, Beck M et al. . Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 2003;417:112–20. 10.1097/01.blo.0000096804.78689.c2
    1. Walker JA, Pagnotto M, Trousdale RT et al. . Preliminary pain and function after labral reconstruction during femoroacetabular impingement surgery. Clin Orthop Relat Res 2012;470:3414–20. 10.1007/s11999-012-2506-1
    1. Palmer DH, Ganesh V, Comfort T et al. . Midterm outcomes in patients with cam femoroacetabular impingement treated arthroscopically. Arthroscopy 2012;28:1671–81. 10.1016/j.arthro.2012.04.154
    1. Naal FD, Miozzari HH, Schar M et al. . Midterm results of surgical hip dislocation for the treatment of femoroacetabular impingement. Am J Sports Med 2012;40:1501–10. 10.1177/0363546512445884
    1. Nho SJ, Magennis EM, Singh CK et al. . Outcomes after the arthroscopic treatment of femoroacetabular impingement in a mixed group of high-level athletes. Am J Sports Med 2011;39(Suppl):14S–19S. 10.1177/0363546511401900
    1. Ribas M, Ledesma R, Cardenas C et al. . Clinical results after anterior mini-open approach for femoroacetabular impingement in early degenerative stage. Hip Int 2010;20(Suppl 7):S36–42. 10.5301/HIP.2010.858
    1. Wall PD, Brown JS, Parsons N et al. . Surgery for treating hip impingement (femoroacetabular impingement). Cochrane Database Syst Rev 2014;(9):CD010796 10.1002/14651858.CD010796.pub2
    1. Diamond LE, Dobson FL, Bennell KL et al. . Physical impairments and activity limitations in people with femoroacetabular impingement: a systematic review. Br J Sports Med 2015;49:230–42. 10.1136/bjsports-2013-093340
    1. Bozic KJ, Chan V, Valone FH III et al. . Trends in hip arthroscopy utilization in the United States. J Arthroplasty 2013;28(8 Suppl): 140–3. 10.1016/j.arth.2013.02.039
    1. Casartelli NC, Maffiuletti NA, Item-Glatthorn JF et al. . Hip muscle weakness in patients with symptomatic femoroacetabular impingement. Osteoarthritis Cartilage 2011;19:816–21. 10.1016/j.joca.2011.04.001
    1. Rylander J, Shu B, Favre J et al. . Functional testing provides unique insights into the pathomechanics of femoroacetabular impingement and an objective basis for evaluating treatment outcome. J Orthop Res 2013;31:1461–8. 10.1002/jor.22375
    1. Lamontagne M, Brisson N, Kennedy MJ et al. . Preoperative and postoperative lower-extremity joint and pelvic kinematics during maximal squatting of patients with cam femoro-acetabular impingement. J Bone Joint Surg Am 2011;93(Suppl 2):40–5. 10.2106/JBJS.J.01809
    1. Schwartz MH, Rozumalski A. The Gait Deviation Index: a new comprehensive index of gait pathology. Gait Posture 2008;28:351–7. 10.1016/j.gaitpost.2008.05.001
    1. Rylander JH, Shu B, Andriacchi TP et al. . Preoperative and postoperative sagittal plane hip kinematics in patients with femoroacetabular impingement during level walking. Am J Sports Med 2011;39(Suppl):36S–42S. 10.1177/0363546511413993
    1. Kennedy MJ, Lamontagne M, Beaule PE. Femoroacetabular impingement alters hip and pelvic biomechanics during gait Walking biomechanics of FAI. Gait Posture 2009;30:41–4. 10.1016/j.gaitpost.2009.02.008
    1. Hunt MA, Guenther JR, Gilbart MK. Kinematic and kinetic differences during walking in patients with and without symptomatic femoroacetabular impingement. Clin Biomech (Bristol, Avon) 2013;28:519–23. 10.1016/j.clinbiomech.2013.05.002
    1. Alradwan H, Khan M, Hamel-Smith Grassby M et al. . Gait and lower extremity kinematic analysis as an outcome measure after femoroacetabular impingement surgery. Arthroscopy 2015;31:339–44. 10.1016/j.arthro.2014.06.016
    1. Casartelli NC, Maffiuletti NA, Item-Glatthorn JF et al. . Hip muscle strength recovery after hip arthroscopy in a series of patients with symptomatic femoroacetabular impingement. Hip Int 2014;24:387–93. 10.5301/hipint.5000131
    1. Harris-Hayes M, Steger-May K, Pashos G et al. . Stride activity level in young and middle-aged adults with hip disorders. Physiother Theory Pract 2012;28:333–43. 10.3109/09593985.2011.639852
    1. Kroman SL, Roos EM, Bennell KL et al. . Measurement properties of performance-based outcome measures to assess physical function in young and middle-aged people known to be at high risk of hip and/or knee osteoarthritis: a systematic review. Osteoarthritis Cartilage 2014;22:26–39. 10.1016/j.joca.2013.10.021
    1. Kivlan BR, Martin RL. Functional performance testing of the hip in athletes: a systematic review for reliability and validity. Int J Sports Phys Ther 2012;7:402–12.
    1. Thorborg K, Holmich P, Christensen R et al. . The Copenhagen Hip and Groin Outcome Score (HAGOS): development and validation according to the COSMIN checklist. Br J Sports Med 2011;45:478–91. 10.1136/bjsm.2010.080937
    1. Tönnis D. Congenital dysplasia and dislocation of the hip in children and adults. Berlin, Germany: Springer, 1987.
    1. Hawker GA, Mian S, Kendzerska T et al. . Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63(Suppl 11):S240–52. 10.1002/acr.20543
    1. Preedy V, Watson R. Handbook of disease burdens and quality of life measures. New York, USA: Springer, 2010.
    1. Mannion AF, Impellizzeri FM, Naal FD et al. . Fulfilment of patient-rated expectations predicts the outcome of surgery for femoroacetabular impingement. Osteoarthritis Cartilage 2013;21:44–50. 10.1016/j.joca.2012.09.013
    1. Paulsen A, Roos EM, Pedersen AB et al. . Minimal clinically important improvement (MCII) and patient-acceptable symptom state (PASS) in total hip arthroplasty (THA) patients 1year postoperatively. Acta Orthop 2014;85:39–48. 10.3109/17453674.2013.867782
    1. Petersen J, Nielsen RO, Rasmussen S et al. . Comparisons of increases in knee and ankle joint moments following an increase in running speed from 8 to 12 to 16km.h. Clin Biomech (Bristol, Avon) 2014;29:959–64. 10.1016/j.clinbiomech.2014.09.003
    1. Monaghan K, Delahunt E, Caulfield B. Increasing the number of gait trial recordings maximises intra-rater reliability of the CODA motion analysis system. Gait Posture 2007;25:303–15. 10.1016/j.gaitpost.2006.04.011
    1. Gandevia SC. Spinal and supraspinal factors in human muscle fatigue. Physiol Rev 2001;81:1725–89.
    1. Ratzlaff C, Simatovic J, Wong H et al. . Reliability of hip examination tests for femoroacetabular impingement. Arthritis Care Res (Hoboken) 2013;65:1690–6. 10.1002/acr.22036
    1. Kjolhede T, Vissing K, de Place L et al. . Neuromuscular adaptations to long-term progressive resistance training translates to improved functional capacity for people with multiple sclerosis and is maintained at follow-up. Mult Scler 2015;21:599–611. 10.1177/1352458514549402
    1. van Rooij WM, Senden R, Heyligers IC et al. . Physical functioning of low back pain patients: perceived physical functioning and functional capacity, but not physical activity is affected. Disabil Rehabil 2015 [epub ahead of print 26 Jul 2015] 10.3109/09638288.2015.1019010
    1. Jacobsen JS, Nielsen DB, Sorensen H et al. . Joint kinematics and kinetics during walking and running in 32 patients with hip dysplasia 1year after periacetabular osteotomy. Acta Orthop 2014;85:1–8. 10.3109/17453674.2014.960167
    1. Thomee R, Jonasson P, Thorborg K et al. . Cross-cultural adaptation to Swedish and validation of the Copenhagen Hip and Groin Outcome Score (HAGOS) for pain, symptoms and physical function in patients with hip and groin disability due to femoro-acetabular impingement. Knee Surg Sports Traumatol Arthrosc 2014;22:835–42. 10.1007/s00167-013-2721-7

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