Editorial Commentary: A Commentary on a Meta-analysis of Short-Term Outcomes

Abstract

Hip pain is prevalent and costly, and young patients with hip femoroacetabular impingement have similar levels of pain and quality of life to older patients with hip osteoarthritis. Hip arthroscopic surgery for femoroacetabular impingement is increasing in prevalence, and the benefits of operative treatment compared with nonoperative treatment require consideration. Hip arthroscopy should not be a first-line treatment but can be necessary in cases in which highquality, exercise-based nonsurgical treatment options have been exhausted. Patients should be informed that surgery is not necessarily cost-effective and may have an increased risk of comorbidities such as chronic pain and insomnia. Patientreported outcomes may improve by up to 20% with either surgery or physical therapy but are not likely to return to those seen in patients without hip pain. Although most patients return to sport after hip arthroscopy, the ability to participate at a preinjury level is seen in fewer than a quarter of patients. Return-to-sport rates with physiotherapist-led nonoperative treatment are not known.

What Happens to a Published Article if a Cited Article Is Corrected?

“…To be fair, in an Editorial Commentary, Kemp wrote, "Hip arthroscopy should not be a first-line treatment but can be necessary in cases in which high-quality, exercise-based nonsurgical treatment options have been exhausted." 4 We conclude that patients with femoroacetabular impingement should undergo a trial of nonoperative management, and if physical therapy fails, surgical treatment is likely to result in a positive patient outcome and a better outcome than after rehabilitation.…”

Arthroscopy Annual Awards: The “Old Normal”

“…21 Kemp summarized her interpretation of this review in her Editorial Commentary: "Hip arthroscopy should not be a first-line treatment for FAI syndrome but can be necessary in cases in which high-quality, exercise-based nonsurgical treatment options have been exhausted." 22 Our other finalists are included in Table 4. [24][25][26]…”

Can’t See the Right Forest Plot for the Wrong Trees!

“…This has, based on what seems to be incorrect reporting using the iHOT-33 scaling by Palmer et al in BMJ, 2 led to (1) an incorrect data point in the metaanalysis 1 and (2) an effect on the accompanying editorial commentary. 6 We have conducted a revised meta-analysis including the correct data and scale in millimeters (Fig 1). For transparency, we present both a fixedand random-effects model, but we prefer to use the random-effects model, since the 3 studies in the metaanalysis 1) concern very different populations (military versus general population), (2) use different eligibility criteria, and (3) lack a transparent description of the nonoperative treatment and postoperative rehabilitation.…”