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Clinical Outcomes of an Initial 3-month Trial of Conservative Treatment for Femoroacetabular Impingement

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Abstract

Background

Femoroacetabular impingement (FAI) can be managed either conservatively or by a surgical correction of the deformity causing impingement. However, there is insufficient evidence to justify an immediate surgical treatment in all symptomatic patients, and the role of a nonoperative treatment is unclear. This study evaluates the role of conservative treatment for FAI.

Materials and Methods

87 patients (102 hips) diagnosed as FAI between January 2011 and May 2012 were included in this retrospective study. All patients underwent an initial 3-month conservative treatment followed by arthroscopic hip surgery if symptoms did not improve. Clinical outcome scores (modified Harris Hip Score, nonarthritic hip score, and Western Ontario and McMaster Universities Arthritis Index) were evaluated at baseline and at the end of followup, and scores were compared between the nonsurgical and surgical groups.

Results

The final analysis included 83 patients (55 men, 28 women; 97 hips) because four patients were lost to followup. The average age was 45.1 years and 14 patients had bilateral symptomatic FAI. After an initial conservative treatment averaging 27.5 months (range 24–36 months), 53 hips (54.6%) could perform normal daily activities. The nonsurgical group had significant improvements in all clinical scores at the end of followup (P < 0.001). Forty four hips (45.4%) were unresponsive to conservative treatment and underwent arthroscopic hip surgery with subsequent significant improvements in clinical scores (P < 0.001). At the end of followup, there were no significant differences in clinical scores between the two groups.

Conclusion

An initial trial of conservative treatment of sufficient length should be considered for FAI patients before surgical intervention.

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Authors and Affiliations

  1. Department Orthopedic Surgery, Seoul National University Boramae Hospital, Seoul, Korea

    Soong Joon Lee & Kang Sup Yoon

  2. Department of Orthopaedic Surgery, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil, 138-736, Songpa-Gu, Seoul, Korea

    Aditya L Kekatpure, Taesoo Ahn, Chul-Ho Kim &  Pil Whan Yoon

Authors
  1. Aditya L Kekatpure
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  2. Taesoo Ahn
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  3. Chul-Ho Kim
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  4. Soong Joon Lee
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  5. Kang Sup Yoon
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Correspondence to Pil Whan Yoon.

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This is an open access artcle distributed under the terms of the Creatve Commons Atributon-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creatons are licensed under the identcal terms.

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Kekatpure, A.L., Ahn, T., Kim, CH. et al. Clinical Outcomes of an Initial 3-month Trial of Conservative Treatment for Femoroacetabular Impingement. IJOO 51, 681–686 (2017). https://doi.org/10.4103/ortho.IJOrtho_212_16

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  • DOI: https://doi.org/10.4103/ortho.IJOrtho_212_16

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