Arthroscopic Surgical Procedures vs Sham Surgery for Patients With Femoroacetabular Impingement and/or Labral Tears. (HIPARTI)
Surgery
About this trial
This is an interventional treatment trial for Surgery focused on measuring hip arthroscopy, femoroacetabular impingement, exercise therapy after hip arthroscopy, rehabilitation after hip arthroscopy
Eligibility Criteria
Inclusion Criteria:
- hip pain during daily and/or spor t ing activities;
- intra-articular hip pain with radiological signs of FAI and/or labral tears eligible for hip arthroscopy (to be determined in a pragmatic fashion by the surgeon based on clinical examination and imaging
- the patient is able to give written informed consent and to participate fully in the interventions and follow-up procedures
Exclusion Criteria:
- pain that is not confirmed by physical examination of the hip
- evidence of preexisting osteoarthritis, defined as Tonnis grade >1, or less than 3mm superior joint space width on AP pelvic radiograph
- center edge angle on radiograph <25°; (v) previous known hip pathology such as Perthes' disease, slipped upper femoral epiphysis or avascular necrosis
- previous hip injury such as acetabular fracture, hip dislocation or femoral neck fracture
- previous hip surgery
- medical conditions complicating surgery (ASA 3); (ix) inflammatory joint disease (RA, Bechterew etc)
- physical inability to undertake testing procedures
- expected lack of compliance such as cognitive impairment, drug abuse or similar;
- inability to understand the written and spoken language of the treatment centre;
- contra-indications to placebo surgery, which will include large loose body, chondral flap >1cm2 detached at 3 sides, complete labral radial flap tear and labral bucket-handle tear with complete avulsion >1.5cm long
Sites / Locations
- LaTrobe University, School Allied Health, College of Science, Helath and EngineeringRecruiting
- Division of Orthopedic Surgery, Oslo University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Placebo Comparator
Active Comparator
Hip arthroscopy surgical procedures (HIPARTI Study)
Sham surgery (HIPARTI Study)
Prospective Cohort (HARP Study)
Surgery is performed under general anaesthesia. Traction and joint access is controlled by fluoroscopy. A diagnostic round in the central and peripheral compartment is performed. Labrum, cartilage, and other possible conditions are looked for and findings are documented. Any labral, chondral and bony pathology (cam or pincer) is treated. Labrum may be debrided, sutured, detached and refixed if needed to treat a pincer lesion. Labrum is secured with suture anchors. Pincer and cam resection is performed using an arthroscopic burr. Cartilage lesions maybe left untreated or treated with debridement or microfracture.
The same arthroscopic procedures as stated above are preformed, but no surgical interventions related to Cam, Pincer, or labral tear are performed, only diagnostic round in the central and peripheral compartment is performed. Labrum, cartilage, and other possible conditions are looked for and findings are documented.
Those that are not willing to be included in the RCT (HIPARTI Study), will be asked if they are willing to be included in the prospective cohort, or ongoing in countries were ONLY the surgery is performed (Australia). They will sign an informed concent and will undergo surgical interventions as part of usual care. Outcomes collected and follow-ups will be the same as for the RCT (HIPARTI).