Conservative Management of Femoroacetabular Impingement
Condition: Femoroacetabular Impingement
MeSH terms: Femoracetabular Impingement
Study type: Interventional

Summary: 
      Femoroacetabular impingement (FAI) is recognized as a formal source of hip pain and
      disability typically affecting the young adult, active population and has been identified as
      a precursor to hip osteoarthritis (OA). Common impairments include sharp, anterior groin pain
      in a position of hip flexion limiting patients' ability to tolerate prolonged sitting,
      squatting, stair climbing, etc. resulting in both work limitations and decreased social
      participation. Manual therapy and exercise is known to be effective in reducing pain and
      increasing physical function in the management of hip OA. To the extent that FAI is often a
      precursor to developing hip OA, logic would seem to dictate a manual therapy plus exercise
      approach to decrease pain and disability and potentially prevent or delay osteoarthritis
      related surgery. Currently, surgery is considered the first line of treatment with respect to
      FAI. However, there is a lack of evidence to support or refute the use of conservative
      treatment interventions in this patient population.

      This study is designed to investigate the benefits of physical therapy interventions (manual
      therapy and exercise) over usual care for improving pain and physical function in patients
      with FAI of the hip. For this study, 52 participants will be recruited from the Department of
      Orthopaedic Surgery, Wake Forest Baptist Medical Center, for an outpatient consultation for
      consideration of hip arthroscopy surgery. Participants will include those patients who meet
      clinical and radiological criteria for formal diagnosis of FAI. Participants will be
      randomized into two treatment groups. Participants in one group will receive usual care plus
      manual therapy directed at the hip as well as a supervised exercise program and home exercise
      program twice weekly for six weeks. Participants in the usual care group will receive usual
      care as prescribed by the physician. Changes in pain, physical function and benefits of the
      intervention will be assessed over six weeks. Should this research study demonstrate
      treatment effectiveness of physical therapy intervention in patients diagnosed with FAI of
      the hip, manual therapy plus exercise may have the potential to delay or prevent surgery in
      this patient population. Further, to the extent to which FAI has been shown to lead to later
      development of hip OA, effective treatment interventions may help to delay or prevent
      secondary osteoarthritis related changes as well as total joint replacement surgery
      associated with hip OA. This study will provide preliminary data that can be used to prepare
      further grant applications designed to determine the safest, most effective treatments for
      patients with FAI.
    


Intervention name(s): Manual therapy plus exercise; Advice and home exercise
Intervention type(s): Other; Other
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment