Pre-operative intra-articular hip injection as a predictor of short-term outcome following arthroscopic management of femoroacetabular impingement.
OBJECTIVE
Diagnostic hip injections are often used to confirm intra-articular pathology prior to arthroscopic treatment for femoroacetabular impingement (FAI). However, little is known whether the type of response correlates with the post-operative functional outcomes. The purpose of this study is to document the ability of a diagnostic hip injection to predict short-term functional outcomes following arthroscopic surgical management.


METHODS
A prospective cohort of 52 patients diagnosed with FAI who had an intra-articular hip injection prior to arthroscopic surgery was evaluated. A pain diary was used during the 2 weeks after hip injection to document response. In addition, the modified Harris Hip Score (mHHS) was administered preoperatively and 6 months post-operatively to assess functional outcomes. The relationship between response to an intra-articular hip injection and mHHS scores 6 months after FAI surgery was evaluated.


RESULTS
Overall, 42 of 52 (81 %) patients diagnosed with FAI achieved pain relief from the hip injection. Outcomes according to mHHS scores improved significantly at the 6-month follow-up visit (19 points, 95 % CI 15-24, p = 0.001). The therapeutic utility of the hip injection suggested that lack of pain relief predicted a lack of functional improvement following arthroscopic surgery.


CONCLUSIONS
In this study, the data suggests that a positive response from an intra-articular hip injection is not a strong predictor of short-term functional outcomes following arthroscopic management of FAI. However, a negative response from an intra-articular hip injection may predict a higher likelihood of having a negative result from surgery.
Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Center, 1200 Main St. West, Room 4E17, Hamilton, ON, L8N 3Z5, Canada, ayenif@mcmaster.ca.
Olufemi R
OR
Ayeni
Forough
F
Farrokhyar
Sarah
S
Crouch
Kevin
K
Chan
Sheila
S
Sprague
Mohit
M
Bhandari
D000293:Adolescent; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D001182:Arthroscopy; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D057925:Femoracetabular Impingement / Q000188:drug therapy* / Q000601:surgery*; D005938:Glucocorticoids / Q000008:administration & dosage; D006621:Hip Joint; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077555:Methylprednisolone Acetate; D008875:Middle Aged; D010865:Pilot Projects; D011300:Preoperative Care; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
D000779:Anesthetics, Local; D005938:Glucocorticoids; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone; D002045:Bupivacaine