IntroductionPeriacetabular osteotomy (PAO) is an established treatment for adolescent and adult patients with hip dysplasia. However, the efficacy of PAO has not been tested against another surgical intervention or conservative treatment in a randomised controlled trial before. We suggest that progressive resistance training (PRT) could be an alternative to PAO. The primary aim of this trial is therefore to examine the efficacy of PAO followed by 4 months of usual care followed by 8 months of PRT compared to 12 months of solely PRT in patients with hip dysplasia eligible for PAO in terms of patient-reported pain measured by The Copenhagen Hip and Groin Outcome Score (HAGOS).Methods and analysisThis trial is a single-blinded multicentre randomised controlled clinical trial, where patients with hip dysplasia, who are eligible for PAO, will be randomised to either PAO followed by usual care and PRT or PRT only. Primary outcome is patient-reported pain, measured on the subscale pain on the HAGOS questionnaire 12 months after initiation of PAO or PRT. The key secondary outcomes are the other subscales of the HAGOS, adverse and serious adverse events, usage of painkillers (yes/no) and type of analgesics. Based on the sample size calculation, the trial needs to include 96 patients.Ethics and disseminationThe trial is approved by the Central Denmark Region Committee on Biomedical Research Ethics (Journal No 1-10-72-234-18) and by the Danish Data Protection Agency (Journal No 1-16-02-120-19). The trial is also approved by The Regional Committee for Medical and Health Research Ethics, Region South-East Norway (Ref. 2018/1603). All results from this trial will be published in international peer-reviewed scientific journals regardless of whether the results are positive, negative or inconclusive.Trial registration numberNCT03941171

BackgroundThe clinical presentation of femoroacetabular impingement syndrome (FAIS) and acetabular hip dysplasia (HD) are similar. However, the groups seem to differ regarding physical activity (PA) and sport. PurposeThe aim was to compare PA between three groups; patients with FAIS, patients with HD, and healthy volunteers. A secondary purpose was to compare self-reported function in sport and recreation (sport/recreation) between patients with FAIS and HD. Study DesignThis study is a cross-sectional study on 157 patients with FAIS or HD and 60 healthy controls. MethodsPA was measured with accelerometer-based sensors, and sport/recreation was measured with the Copenhagen Hip and Groin Outcome Score (HAGOS). Data on patients with FAIS or HD and healthy volunteers were collected in other studies and merged for comparison in this study. ResultsFifty-five patients with FAIS (20 males; mean age 36 years), 97 patients with HD (15 males; mean age 30 years) and 60 healthy volunteers (24 males; mean age 31 years) were included. Compared with patients with HD, patients with FAIS spent more time on very low intensity PA (mean 73 minutes (95% CI: 45;102)) and less time on low intensity PA per day (mean -21 minutes (95% CI: -37;-6)). Both groups spent less time on high intensity PA per day compared with healthy volunteers (p≤0.03). However, sport/ recreation did not differ between the two groups (FAIS: median 34 points (IQR: 22;50) and HD: median 38 points (IQR: 25;53), p=0.16). ConclusionPatients with FAIS appear to be less physical active compared with patients with HD.

Exercise is now considered medicine in numerous chronic conditions and is essentially without side effects. We hypothesize that exercise is primary, secondary, and tertiary prevention at different stages of hip osteoarthritis (preclinical, mild-moderate, and severe hip osteoarthritis) and after total hip arthroplasty.

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