Objective To report a 3-year follow-up from the FemoroAcetabular Impingement Trial, comparing arthroscopic surgery with physiotherapy in the management of femoroacetabular impingement (FAI) syndrome for the dual primary outcomes of radiographic hip osteoarthritis (OA) and patient-reported outcome measures of activities of daily living. Methods Two-group parallel, assessor-blinded, pragmatic randomised controlled trial across seven sites. 222 participants aged 18–60 years with FAI syndrome confirmed clinically and radiologically were randomised (1:1) to receive arthroscopic hip surgery (n=112) or physiotherapy (n=110). Dual primary outcome measure was minimum joint space width (mJSW) on anteroposterior radiograph at 38 months post-randomisation and Hip Outcome Score ADL (HOS ADL) (higher score indicates superior outcomes). Secondary outcome measures were Scoring Hip Osteoarthritis with MRI (SHOMRI) (lower score indicates less pathology). Results mJSW, HOS ADL and MRI data were available for 45%, 77% and 62% of participants at 38 months, respectively. No significant difference in mJSW was seen between groups at 38 months. HOS ADL was higher in the arthroscopy group (mean (SD) 84.2 (17.4)) compared with the physiotherapy group (74.2 (21.9)), difference 8.9 (95% CI 7.0, 10.8)). SHOMRI score total at 38 months was lower in the arthroscopy group (mean (SD) 9.22 (11.43)) compared with the physiotherapy group (22.76 (15.26)), differences (95% CIs) −15.94 (–18.69, –13.19). Conclusions No difference was seen between groups on radiographic measures of OA progression. Patients with FAI syndrome treated surgically may experience superior pain and function outcomes, and less MRI-measured cartilage damage compared with physiotherapy. Trial registration number [NCT01893034][1]. Data are available upon reasonable request. Anonymised patient level data can be made available on reasonable request after approval from the trial management committee and after signing a data access agreement. Proposals should be directed to the corresponding author. Consent was not obtained for data sharing but the presented data is anonymised and the risk of identification is low. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01893034&atom=%2Fbjsports%2Fearly%2F2024%2F11%2F26%2Fbjsports-2023-107712.atom

中文翻译：

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关节镜髋关节手术与物理治疗和活动调整治疗股骨髋臼撞击综合征的中期结果：一项多中心随机对照试验


目的 报告股骨髋臼撞击试验的 3 年随访，比较关节镜手术与物理治疗治疗股骨髋臼撞击 （FAI） 综合征对影像学髋关节骨关节炎 （OA） 的双重主要结局和患者报告的日常生活活动结局测量。方法 在 7 个地点进行两组平行、评估员盲法、务实的随机对照试验。222 名年龄在 18-60 岁之间经临床和放射学证实的 FAI 综合征参与者被随机分配 （1：1） 接受关节镜髋关节手术 （n=112） 或物理治疗 （n=110）。双重主要结局指标是随机分组后 38 个月前后位 X 光片上的最小关节间隙宽度 （mJSW） 和髋关节结局评分 ADL （HOS ADL） （评分越高表示结局越好）。次要结局指标是 MRI 髋骨关节炎评分 （SHOMRI） （分数越低表示病理效果越少）。结果 45% 、 77% 和 62% 的参与者在 38 个月时分别获得 mJSW 、 HOS ADL 和 MRI 数据。38 个月时，两组间 mJSW 无显著差异。关节镜检查组 （平均值 （SD） 84.2 （17.4）） 高于物理治疗组 （74.2 （21.9）），差异 8.9 （95% CI 7.0,10.8））。与物理治疗组 （22.76 （15.26）） 相比，关节镜检查组 38 个月时的 SHOMRI 总分 （平均值 （SD） 9.22 （11.43）） 较低，差异 （95% CI） 为 -15.94 （-18.69， -13.19）。结论 两组间 OA 进展的影像学测量无差异。与物理治疗相比，手术治疗的 FAI 综合征患者可能会经历更好的疼痛和功能结果，并且 MRI 测量的软骨损伤更少。试验注册号 [NCT01893034][1]。 数据可根据合理要求提供。在获得试验管理委员会的批准并签署数据访问协议后，可以根据合理要求提供匿名的患者水平数据。提案应直接发送给通讯作者。数据共享未获得同意，但所提供的数据是匿名的，被识别的风险很低。[1]： /lookup/external-ref？link_type=CLINTRIALGOV&access_num=NCT01893034&atom=%2Fbjsports%2Fearly%2F2024%2F11%2F26%2Fjsports-2023-107712.原子