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Factors Associated with Initial Interest and Treatment Selection in Patients with Femoroacetabular Impingement Syndrome.
PM R. 2020 Feb 14 [Online ahead of print]PM R

Abstract

BACKGROUND

Outcomes for operative and nonoperative management of femoroacetabular impingement syndrome (FAIS) are variable. Understanding factors that inform patients' treatment decisions may optimize their outcomes.

OBJECTIVE

To identify factors that predict which patients with FAIS proceed to surgery within 90 days of their initial evaluation by an orthopedic surgeon. The study explored potential predictors of surgical intervention, including demographic factors, activity level, symptom duration, previous treatment, hip function, pain, presence of labral tear, and patient interest in surgical and physical therapy (PT) treatment.

DESIGN

Prospective cohort.

SETTING

Single-site academic medical center.

PATIENTS

Seventy-seven individuals with FAIS.

INTERVENTION

After evaluation in a hip preservation clinic, participants reported activity level, symptom duration, treatment history, hip function [Hip Outcome Score Activities of Daily Living(HOS-ADL)], pain severity and location, and treatment interests. These variables were evaluated based on univariate analysis for entry into a multiple binomial logistic regression to identify predictors of surgery within 90 days. Adjusted marginal prevalence ratios and 95% confidence interval estimates (PR [95% CI]) were reported (P ≤ .05).

MAIN OUTCOME MEASURE(S)

Ninety-day treatment (surgery or not).

RESULTS

Participants indicated initial interest in surgery (n = 27), PT (n = 22), both (n = 18), or neither (n = 10). Those only interested in PT had lower prevalence of diagnosed labral tear (P < .001) and previous PT for the hip (P < .001). Prevalence of previous injection was higher for those only interested in surgery than for those with any interest in PT (P < .001). Thirty-six of 77 participants (46%) underwent surgery within 90 days. Surgical interest (3.56 [1.57, 5.46]), previous hip injection (3.06 [1.73, 3.89]), younger age (0.95 [0.92, 0.98]), and worse hip function (0.97 [0.95, 0.99]) were significant (P ≤ .02) predictors of surgery.

CONCLUSIONS

Treatment interest and history, patient function, and age were significantly related to participants' decision to pursue surgical intervention within 90 days. Patient engagement in the decision-making process should include considerations of patient knowledge of, and experience with, the various treatment options.

Authors+Show Affiliations

Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Health and Rehabilitation Sciences Doctoral Program, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA.Department of Physical Therapy, College of Health, University of Utah, Salt Lake City, UT.Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Department of Orthopaedics, The Ohio State University, Columbus, OH, USA.Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Department of Family Medicine, The Ohio State University, Columbus, OH, USA.Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Department of Orthopaedics, The Ohio State University, Columbus, OH, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32061048

Citation

Glaws, Kathryn, et al. "Factors Associated With Initial Interest and Treatment Selection in Patients With Femoroacetabular Impingement Syndrome." PM & R : the Journal of Injury, Function, and Rehabilitation, 2020.
Glaws K, Brown-Taylor L, Pomeroy M, et al. Factors Associated with Initial Interest and Treatment Selection in Patients with Femoroacetabular Impingement Syndrome. PM R. 2020.
Glaws, K., Brown-Taylor, L., Pomeroy, M., Di Stasi, S., Fritz, J. M., Ryan, J., Walrod, B., & Vasileff, W. K. (2020). Factors Associated with Initial Interest and Treatment Selection in Patients with Femoroacetabular Impingement Syndrome. PM & R : the Journal of Injury, Function, and Rehabilitation. https://doi.org/10.1002/pmrj.12344
Glaws K, et al. Factors Associated With Initial Interest and Treatment Selection in Patients With Femoroacetabular Impingement Syndrome. PM R. 2020 Feb 14; PubMed PMID: 32061048.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors Associated with Initial Interest and Treatment Selection in Patients with Femoroacetabular Impingement Syndrome. AU - Glaws,Kathryn, AU - Brown-Taylor,Lindsey, AU - Pomeroy,Matthew, AU - Di Stasi,Stephanie, AU - Fritz,Julie M, AU - Ryan,John, AU - Walrod,Bryant, AU - Vasileff,William K, Y1 - 2020/02/14/ PY - 2019/07/01/received PY - 2020/01/29/revised PY - 2020/02/10/accepted PY - 2020/2/16/pubmed PY - 2020/2/16/medline PY - 2020/2/16/entrez JF - PM & R : the journal of injury, function, and rehabilitation JO - PM R N2 - BACKGROUND: Outcomes for operative and nonoperative management of femoroacetabular impingement syndrome (FAIS) are variable. Understanding factors that inform patients' treatment decisions may optimize their outcomes. OBJECTIVE: To identify factors that predict which patients with FAIS proceed to surgery within 90 days of their initial evaluation by an orthopedic surgeon. The study explored potential predictors of surgical intervention, including demographic factors, activity level, symptom duration, previous treatment, hip function, pain, presence of labral tear, and patient interest in surgical and physical therapy (PT) treatment. DESIGN: Prospective cohort. SETTING: Single-site academic medical center. PATIENTS: Seventy-seven individuals with FAIS. INTERVENTION: After evaluation in a hip preservation clinic, participants reported activity level, symptom duration, treatment history, hip function [Hip Outcome Score Activities of Daily Living(HOS-ADL)], pain severity and location, and treatment interests. These variables were evaluated based on univariate analysis for entry into a multiple binomial logistic regression to identify predictors of surgery within 90 days. Adjusted marginal prevalence ratios and 95% confidence interval estimates (PR [95% CI]) were reported (P ≤ .05). MAIN OUTCOME MEASURE(S): Ninety-day treatment (surgery or not). RESULTS: Participants indicated initial interest in surgery (n = 27), PT (n = 22), both (n = 18), or neither (n = 10). Those only interested in PT had lower prevalence of diagnosed labral tear (P < .001) and previous PT for the hip (P < .001). Prevalence of previous injection was higher for those only interested in surgery than for those with any interest in PT (P < .001). Thirty-six of 77 participants (46%) underwent surgery within 90 days. Surgical interest (3.56 [1.57, 5.46]), previous hip injection (3.06 [1.73, 3.89]), younger age (0.95 [0.92, 0.98]), and worse hip function (0.97 [0.95, 0.99]) were significant (P ≤ .02) predictors of surgery. CONCLUSIONS: Treatment interest and history, patient function, and age were significantly related to participants' decision to pursue surgical intervention within 90 days. Patient engagement in the decision-making process should include considerations of patient knowledge of, and experience with, the various treatment options. SN - 1934-1563 UR - https://www.unboundmedicine.com/medline/citation/32061048/Factors_Associated_with_Initial_Interest_and_Treatment_Selection_in_Patients_with_Femoroacetabular_Impingement_Syndrome L2 - https://doi.org/10.1002/pmrj.12344 DB - PRIME DP - Unbound Medicine ER -
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