title: Surgeon Willingness to Participate in Randomized Controlled Trials for the Treatment of Femoroacetabular Impingement.
abstract: OBJECTIVE
  To define surgeon willingness to participate in large, multicenter randomized controlled trials (RCTs) to address common treatment decisions for the management of femoroacetabular impingement (FAI) and to define the feasibility of executing these RCTs.
  
  
  METHODS
  Thirty case vignettes of consecutive, symptomatic FAI patients who underwent FAI corrective surgery by a single surgeon were provided to members of the Academic Network of Conservational Hip Outcomes Research (ANCHOR). Each surgeon (n = 10) completed a questionnaire in a blinded fashion to determine willingness to participate and enroll the patient in 6 different potential RCTs. The proportion of yes/no ratings were blindly assessed for all 6 RCTs. Differences were tested with χ(2)-tests, and odds ratios were calculated.
  
  
  RESULTS
  Seventy-seven percent and 42% of surgeons were willing to enroll patients in a surgical versus nonoperative FAI RCT with 6-month and 12-month crossover arms, respectively. Only 25% and 53% of surgeons were willing to consider randomization of operative versus nonoperative treatment for femoral and acetabular sided osseous deformities, respectively. Regarding the capsulolabral complex, 63% and 78% were amenable to randomization of labral refixation versus debridement and capsular closure versus no closure, respectively. Statistically, surgeon ratings differed significantly (Pearson χ(2) = 246.302; P < .001).
  
  
  CONCLUSIONS
  Surgeons are willing to participate in surgical versus nonsurgical trials with a 6-month crossover endpoint, yet surgeons are reluctant to offer surgical treatment of FAI without correction of osseous deformity, particularly for cam-type pathomorphology. RCTs to address management of the capsulolabral structures may be more feasible and generalizable based on the willingness of hip preservation surgeons to enroll patients.
  
  
  CONCLUSIONS
  The feasibility of completing RCTs for the management of FAI is limited even among high-volume hip preservation surgeons; however, surgeons are willing to participate.
authors.affiliation: BocaCare Orthopedics, Florida Atlantic University - College of Medicine, Boca Raton, Florida, U.S.A.
authors.forename: James R
authors.initials: JR
authors.lastname: Ross
authors.affiliation: Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.; Hospital for Special Surgery, New York, New York, U.S.A.. Electronic address: abedi@med.umich.edu.
authors.forename: Asheesh
authors.initials: A
authors.lastname: Bedi
authors.affiliation: Department of Orthopedic Surgery, Washington University in St. Louis, St. Louis, Missouri, U.S.A.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.affiliation: Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
authors.forename: Joel J
authors.initials: JJ
authors.lastname: Gagnier
authors.affiliation: Minnesota Orthopedic Sports Medicine Institute at Twin Cities Orthopedics, Edina, Minnesota, U.S.A.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Larson
mesh_terms: D001291:Attitude of Health Personnel; D005240:Feasibility Studies; D057925:Femoracetabular Impingement / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D035842:Research Subjects; D066231:Surgeons; D011795:Surveys and Questionnaires