Osteochondroplasty Benefits the Pragmatic Patient With Femoroacetabular Impingement: Analysis From the Embedded Prospective Cohort of the Femoroacetabular Impingement RandomiSed Controlled Trial (FIRST)

Almasri, Mahmoud; Simunovic, Nicole; Heels‐Ansdell, Diane; Ayeni, Olufemi R.; Bhandari, Mohit; Bedi, Asheesh; Järvinen, Tero A.H.; Musahl, Volker; Naudie, Douglas; Seppänen, Matti; Slobogean, Gerard P.; Thabane, Lehana; Duong, Andrew; Skelly, Matthew; Shanmugaraj, Ajay; Crouch, Sarah; Sprague, Sheila; Buckingham, Lisa; Ramsay, Tim; Lee, John; Kousa, Petteri; Carsen, Sasha; Choudur, Hema; Sim, Yan; Johnston, Kelly; Wong, Ivan; Murphy, Ryland; Sparavalo, Sara; Whelan, Daniel B.; Khan, Ryan; Wood, Gavin; Howells, Fiona; Grant, Heather; Zomar, Bryn O.; Pollock, Michael; Willits, Kevin; Firth, Andrew; Wanlin, Stacey; Remtulla, Alliya; Kaniki, Nicole; Belzile, Étienne L.; Turmel, Sylvie; Jørgensen, U. G.; Gam-Pedersen, Annie; Hatanpää, Tays; Sihvonen, Raine; Raivio, Marko; Toivonen, Pirjo; Routapohja, Mari Pirjetta

doi:10.1016/j.arthro.2021.06.026

Cited by 7 publications

(14 citation statements)

References 36 publications

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“…Eight of the 8 studies did not meet the inclusion criteria. Six studies met the inclusion criteria and were included in the systematic review and meta-analysis 22 – 27 (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

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RETRACTED ARTICLE: Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: a systematic review and meta-analysis of randomized clinical trials

Lamo-Espinosa,

Mariscal,

Gómez-Álvarez

et al. 2023

Sci Rep

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This study aimed to compare the efficacy and safety of arthroscopy with physiotherapy or joint lavage in patients with femoroacetabular impingement (FAI). A meta-analysis using PubMed, Embase, Scopus, and the Cochrane Collaboration Library databases was performed in September 2022. We included studies focusing on patients with FAI who underwent arthroscopic surgery versus those who underwent physiotherapy or arthroscopic lavage. The outcomes were functional scores (iHOT-33 and HOS ADL) and adverse events. Randomized clinical trials were included in the study. The risk of bias in each study was assessed according to Cochrane guidelines for clinical trials. The data were combined using Review Manager version 5.4. (PROSPERO CRD42022375273). Six RCTs were included, from a pool of 839 patients (407 females). The iHOT-33 and HOS ADL scales showed significant differences at 12 months in favor of the arthroscopy group (MD, 10.65; 95% CI 6.54–4.76) and (MD, 8.09; 95% CI 3.11–13.07). MCID was not achieved through arthroscopy in functional variables. The rates of osteoarthritis (OR, 6.18; 95% CI 1.06–36.00) and numbness (OR, 73.73; 95% CI 10.00–43.92) were significantly higher in the arthroscopy group. Arthroscopic surgery showed statistical superiority over the control group without exceeding the MCID in most studies; however, the results might have been influenced by secondary variables. Finally, arthroscopic surgery results in a high rate of conversion to osteoarthritis.

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“…Eight of the 8 studies did not meet the inclusion criteria. Six studies met the inclusion criteria and were included in the systematic review and meta-analysis 22 – 27 (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…A total of six randomized clinical trials published between 2018 and 2021 were included (Table 1 ) 22 – 27 . A total of 839 patients were included, with 418 in the arthroscopy group and 421 in the control group.…”

Section: Resultsmentioning

confidence: 99%

RETRACTED ARTICLE: Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: a systematic review and meta-analysis of randomized clinical trials

Lamo-Espinosa,

Mariscal,

Gómez-Álvarez

et al. 2023

Sci Rep

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“…Study Characteristics. A total of six randomized clinical trials published between 2018 and 2021 were included (Table 1) [15][16][17][18][19][20] . A pool of 839 patients was included: 418 in the arthroscopy group and 421 in the control group.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: A systematic review and meta-analysis

Lamo-Espinosa

Mariscal

Gómez-Álvarez

et al. 2023

Preprint

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The aim of this study was to compare, in terms of efficacy and safety, arthroscopy with physiotherapy or joint lavage in patients with femoroacetabular impingement (FAI). A meta-analysis using PubMed, Embase, Scopus, and the Cochrane Collaboration Library database was carried out in September 2022. We included studies focusing on patients with FAI undergoing arthroscopic surgery versus physiotherapy or arthroscopic lavage. Outcomes were functional scores (iHOT-33 and HOS ADL) and adverse events. We included randomized clinical trials. Data was combined using Review Manager 5.4. (PROSPERO: CRD42022375273). A total of six RCTs were included from a pool of 839 patients (407 females). iHOT-33 and HOS ADL scales showed significant differences at 12 months in favour of the arthroscopy group (MD 10.65; 95% CI; 6.54–4.76) and (MD 8.09; 95% CI; 3.11–13.07). MCID was not achieved through arthroscopy in functional variables. The rate of osteoarthritis (OR 6.18; 95% CI; 1.06–36.00) and numbness (OR 73.73; 95% CI; 10.00-43.92) was significantly high in the arthroscopy group. Arthroscopic surgery showed statistical superiority over the control group without exceeding MCID in most studies; however, the results might have been influenced by secondary variables. Finally, arthroscopic surgery showed a high rate of conversion to osteoarthritis.

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“…The sexual function questionnaires used in this study (IIEF, FSFI) focus mainly on satisfaction with sexual intercourse and genital-related symptoms, but do not specifically ask about hip pain during sex. While the position aspect and hip pain during sexual intercourse may have been an avenue to explain the difference we found between osteochondroplasty patients in FIRST and EPIC, prior analysis has shown that there are no differences between FIRST and EPIC patients with respect to hip pain, hip function and health-related quality of life postoperatively [ 41 ]. We expect that the small sample size and the MD showing only a 2-point difference means this finding is likely not clinically significant.…”

Section: Discussionmentioning

confidence: 95%

Sexual and urinary function post-surgical treatment of femoroacetabular impingement: experience from the FIRST trial and embedded cohort study

Jean

Simunovic

Duong

et al. 2022

Journal of Hip Preservation Surgery

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The goal of this study was to investigate the sexual and urinary function and any related complications in patients post-hip arthroscopy for the treatment of femoroacetabular impingement (FAI). Data from 214 patients enrolled in the FIRST trial and 110 patients enrolled in the trial’s embedded prospective cohort study (EPIC) were analyzed. EPIC patients either refused to participate in the trial or did not meet the FIRST eligibility criteria. Outcomes included the International Consultation on Continence Questionnaire (ICIQ) for males (ICIQ-MLUTS) and females (ICIQ-FLUTS) and the Female Sexual Function Index (FSFI) and International Index of Erectile Function (IIEF) administered before surgery and at 6 weeks and 12 months. Urinary and sexual function adverse events were recorded up to 24 months. Linear regression analyses were conducted to compare the osteochondroplasty and lavage groups in the FIRST trial and to evaluate age and traction time as prognostic factors among all patients. Longer traction time was associated with a small but statistically significant improvement in urinary voiding function in males at 6 weeks and 12 months (MD (95% CI) = 0.25 (0.12, 0.39), P < 0.001 and 0.21 (0.07, 0.35), P = 0.004), respectively. Mean traction time was 43.7 (± 23.2) min for FIRST trial and 52.8 (± 15.2) min for EPIC cohort patients. Increasing age in male patients was associated with a decrease in urinary continence at 6 weeks (MD (95% CI) = 0.25 (−0.42, −0.09), P = 0.003). FIRST male patients who received osteochondroplasty improved significantly in sexual function at 12 months compared to males in the EPIC cohort (MD (95% CI) = 2.02 (0.31, 3.72), P = 0.020). There was an overall complication rate of 1.2% at 24 months [one urinary infection, two instances of erectile dysfunction (one transient and one ongoing at 24 months) and one reported transient numbness of tip of the penis]. Hip arthroscopy for the treatment of FAI has a low rate of sexual and urinary dysfunction and adverse events.

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Osteochondroplasty Benefits the Pragmatic Patient With Femoroacetabular Impingement: Analysis From the Embedded Prospective Cohort of the Femoroacetabular Impingement RandomiSed Controlled Trial (FIRST)

Cited by 7 publications

References 36 publications

RETRACTED ARTICLE: Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: a systematic review and meta-analysis of randomized clinical trials

RETRACTED ARTICLE: Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: a systematic review and meta-analysis of randomized clinical trials

Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: A systematic review and meta-analysis

Sexual and urinary function post-surgical treatment of femoroacetabular impingement: experience from the FIRST trial and embedded cohort study

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