PMID- 34357811
OWN - NLM
STAT- MEDLINE
DCOM- 20210903
LR  - 20220622
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 49
IP  - 11
DP  - 2021 Sep
TI  - Nonoperative Management of Femoroacetabular Impingement in Adolescents: Clinical 
      Outcomes at a Mean of 5 Years: A Prospective Study.
PG  - 2960-2967
LID - 10.1177/03635465211030512 [doi]
AB  - BACKGROUND: There is a lack of midterm or long-term outcome data on nonoperative 
      management of femoroacetabular impingement (FAI) syndrome in adolescents despite 
      expanding research mostly focused on arthroscopic management. PURPOSE: To present 
      5-year outcome data utilizing a nonoperative protocol on a consecutive series of 
      patients presenting to our clinic with FAI syndrome. STUDY DESIGN: Cohort study, 
      Level of evidence, 2. METHODS: A total of 100 patients (62% female; mean age 15 
      years) who presented to the clinic for evaluation of hip pain and had at least 1 
      hip with a positive impingement sign were prospectively recruited. The management 
      protocol consisted of an initial trial of rest, physical therapy, and activity 
      modification. Patients who remained symptomatic were offered an intra-articular 
      steroid injection. Patients with recurrent symptoms were then offered 
      arthroscopic treatment. Patient-reported outcomes (PROs), including the modified 
      Harris Hip Score (mHHS) and the Nonarthritic Hip Score (NAHS) were then collected 
      at a mean 1, 2, and 5 years after the initial evaluation. RESULTS: At enrollment, 
      the mean mHHS and NAHS were 69.6 +/- 12.9 and 75.5 +/- 15.2, respectively. A total of 
      51 patients (n = 69 hips) were available at a mean 5-year follow-up, with the 
      mean mHHS and NAHS of 89.5 +/- 10.8 and 88.1 +/- 12, respectively. There was no 
      significant difference in the mHHS or the NAHS between activity modification and 
      physical therapy, injection, or arthroscopic surgery groups at 5-year follow-up 
      (P > .6) and no difference in the proportion of hips meeting the minimal 
      clinically important difference (MCID) for the mHHS based on treatment course (P 
      = .99). There was no significant difference in the mHHS or the NAHS between FAI 
      types at any time point, or in the proportion of hips that met the MCID among FAI 
      types (P = .64). Also, 11 out of 12 hips that required surgery had surgery in 
      less than 2 years. One hip underwent surgery at 5 years after the initial visit. 
      There was no significant drop-off in the mHHS or the NAHS between the 2-year and 
      5-year time periods (P > .3). CONCLUSION: Nonoperative management of FAI syndrome 
      is effective in a majority of adolescent patients, with significant improvements 
      in PROs persisting at a mean 5-year follow-up.
FAU - Zogby, Andrew M
AU  - Zogby AM
AD  - University of California, San Diego, California, USA.
AD  - Rady Children's Hospital, San Diego, California, USA.
FAU - Bomar, James D
AU  - Bomar JD
AD  - University of California, San Diego, California, USA.
AD  - Rady Children's Hospital, San Diego, California, USA.
FAU - Johnson, Kristina P
AU  - Johnson KP
AD  - University of California, San Diego, California, USA.
AD  - Rady Children's Hospital, San Diego, California, USA.
FAU - Upasani, Vidyadhar V
AU  - Upasani VV
AD  - University of California, San Diego, California, USA.
AD  - Rady Children's Hospital, San Diego, California, USA.
FAU - Pennock, Andrew T
AU  - Pennock AT
AUID- ORCID: 0000-0002-8628-5603
AD  - University of California, San Diego, California, USA.
AD  - Rady Children's Hospital, San Diego, California, USA.
LA  - eng
PT  - Journal Article
DEP - 20210806
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
CIN - Am J Sports Med. 2022 May;50(6):NP29-NP30. PMID: 35507466
CIN - Am J Sports Med. 2022 May;50(6):NP30-NP31. PMID: 35507467
MH  - Adolescent
MH  - Arthroscopy
MH  - Cohort Studies
MH  - Female
MH  - *Femoracetabular Impingement/surgery
MH  - Follow-Up Studies
MH  - Hip Joint
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - adolescent hip pain
OT  - femoroacetabular impingement syndrome
OT  - labral tear
OT  - nonoperative treatment
EDAT- 2021/08/07 06:00
MHDA- 2021/09/04 06:00
CRDT- 2021/08/06 17:13
PHST- 2021/08/07 06:00 [pubmed]
PHST- 2021/09/04 06:00 [medline]
PHST- 2021/08/06 17:13 [entrez]
AID - 10.1177/03635465211030512 [doi]
PST - ppublish
SO  - Am J Sports Med. 2021 Sep;49(11):2960-2967. doi: 10.1177/03635465211030512. Epub 
      2021 Aug 6.