title: Feasibility of a Randomized Clinical Trial for Treatment of Femoroacetabular Impingement of the Hip.
abstract: BACKGROUND
  Symptomatic femoroacetabular impingement (FAI) is currently corrected by surgery. However, it is possible that nonsurgical treatment could resolve symptomatic FAI in some patients; thus, uncertainty about the necessity of surgical treatment exists. The current equipoise concerning FAI treatment presents an opportunity to conduct a randomized controlled trial (RCT) of surgical and nonsurgical treatment options. Given the unique challenge of adequate patient enrollment in RCTs, it is important that a preliminary study is done to appraise the feasibility of conducting an RCT.
  
  
  OBJECTIVE
  To estimate enrollment rates of a planned future RCT to compare surgical and nonsurgical treatments for symptomatic FAI and to identify factors associated with patients' willingness to participate in the randomized trial.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 4.
  
  
  METHODS
  Patients diagnosed with FAI at 2 orthopaedic centers were presented with a hypothetical randomized trial comparing 2 treatment options for FAI. All patients completed forms providing information regarding their willingness to participate and treatment preferences.
  
  
  RESULTS
  A total of 75 patients participated in the study: 53 and 22 from 2 centers, respectively. Twenty-eight percent indicated absolute willingness to participate in the trial, 40% were probably willing or unsure, and 32% were definitely not willing; 18.7% had a strong preference for surgery while 2.7% strongly preferred nonsurgical treatment. The majority (78.6%) had no strong preference for either treatment arm. There were correlations between treatment preferences and willingness to participate. Patients with a strong treatment preference and/or a preference for surgery were less likely to be willing to participate.
  
  
  CONCLUSIONS
  The study findings suggest that sufficient patient accrual for a randomized trial of FAI treatment is currently feasible while equipoise still exists among patients and surgeons.
authors.affiliation: Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Gloria N
authors.initials: GN
authors.lastname: Boye
authors.affiliation: Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Kerri
authors.initials: K
authors.lastname: Murray
authors.affiliation: Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.affiliation: Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
keywords: feasibility study; femoroacetabular impingement (FAI); nonsurgical treatment; randomized clinical trial; surgical treatment