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Hip arthroscopy seen as gold standard for femoroacetabular impingement
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BOSTON — A presenter at the American Orthopaedic Society of Sports Medicine Annual Meeting discussed recommendations, practices and protocols in the first national consensus-based best practice guidelines for hip arthroscopy in patients with femoroacetabular impingement.
“Those individuals who shouldn’t be having hip arthroscopy are those who have signs of hip arthritis, as well as those who have dysplasia on either femoral or acetabular side,” Thomas Sean Lynch, MD, said during his presentation.
Using the Delphi process, Lynch and colleagues brought together 15 hip arthroscopy experts to establish best practice guidelines for hip arthroscopy for patients with femoroacetabular impingement. The hip arthroscopy experts were given a survey to answer questions on current practices, were shown results from a meta-analysis and systematic literature review and had to vote for or against inclusion of non-leading, impartially phrased items. Agreements were considered consensus when the agreement was greater than 80%.
“From a preoperative perspective, we addressed nonoperative care consisting of rest, anti-inflammatories [and] physical therapy, as well as the nonuse of opioids,” Lynch said.
The surgeons reached a consensus for the best practice guidelines with a final checklist, which included 27 preoperative recommendations, 15 intraoperative practices and 10 postoperative protocols.
Lynch said hip arthroscopy should be the gold standard with labral repair compared with debridement. As far as postoperative protocols go, Lynch said physical therapy is paramount for patients who undergo hip arthroscopy. They should not be non-weight bearing at any point after the surgery.
“As evidence becomes available, these guidelines will be updated accordingly,” Lynch said. – by Monica Jaramillo
Reference:
Lynch TS, et al. Abstract 73. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2019; Boston.
Disclosure: Lynch reports no relevant financial disclosures.