FDA Status: Not Applicable
Summary: In this study we show that natural history of untreated symptomatic femoroacetabular impingement causes worsening patient reported outcomes over an average of 13 months.
Purpose: Femoroacetabular impingement (FAI) is a common cause of hip pain, however the natural history of pain and function in people with symptomatic FAI is not known. The aim of this study was to determine the patient reported outcomes in symptomatic FAI over a 1 to 2 year time period.
Method: Participants were recruited from the practice of a single orthopaedic surgeon. Inclusion criteria were a clinical diagnosis of FAI and a radiographic diagnosis of FAI confirmed by a cam and/or pincer lesion present on MRI. Participants did not undergo any surgical or medical intervention over the course of the study. Patient reported outcomes were collected at baseline and at 6-24 month time points. Patient reported outcomes collected were the Harris Hip Score (HHS), the Non-arthritic Hip Score (NAHS) and the [Multicenter Arthroscopy of the Hip Outcomes Research Network (MAHORN) Hip Outcomes Tool] (MHOT14).
Results: Forty-three participants (17 male, 26 female) were recruited between June 2013 and November 2015 with mean (standard deviation(SD)) age 45(16) years and mean BMI 26.2(5.4). The mean follow up time was 13(7) months. There was a significant mean difference in the NAHS of 6.7 (p = 0.025) (95%CI 0.9-12.5) and the MHOT14 of 5.0 (p = 0.034) (95%CI 0.4-9.6). There was no significant difference for the HHS between time points (Mean difference = 1.0 (p = 0.691) (95%CI 4.1-6.1).
Conclusion: These findings suggest there may be a deterioration of patient reported outcomes in patients with symptomatic FAI without medical or surgical intervention over a 1-2 year time period. Future studies with larger cohorts are required to confirm these findings, examine factors influencing outcomes, and determine whether interventions alter this deterioration.