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Tears of the acetabular labrum appear to be common with the prevalence of asymptomatic tears in the general population approaching 66% and 70% based on cadaveric dissection and magnetic resonance imaging, respectively. Despite this prevalence, there is no currently accepted justification for performing labral repair in an asymptomatic patient despite the many postulated biomechanical benefits that an intact labrum imparts to the hip joint.
Representing a smaller proportion of all tears, symptomatic tears of the acetabular labrum present a therapeutic challenge. Current treatment modalities range from conservative measures to open surgical intervention. Conservative measures have typically included: activity modification, the use of non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy (PT), core strengthening and improvement of sensory motor control. In the past two decades, technological advances in the form of surgical instrumentation and traction devices have facilitated less invasive arthroscopic techniques to diagnose and treat hip problems and as such is now the preferred treatment modality for many orthopedic surgeons treating patients with hip pathology.
Determining which patients, using age and arthritic burden as predictors, can benefit from labral repair is paramount for several reasons. Showing arthroscopic repair is of little or no benefit to a specific cohort can reduce the number of unnecessary surgeries performed, increase the use of conservative therapy (if validated) and reduce the interval between diagnosis and total hip replacement.
There has been only one prospective study documenting the outcomes of patients treated with physical therapy for intra-articular conditions of the hip. These conditions included mild FAI and mild developmental dysplasia of the hip. Here, physical therapy was given as a first line treatment. Those who did not make satisfactory improvements in pain or wished to have surgery were then scheduled for surgery to repair the defects. Patients saw improvement in validated outcome measures at one year.
Although there have been studies looking at age secondarily in patients with labral tears, there is no prospective evidence to endorse or refute a recommendation of hip arthroscopy for patients of any age being treated for a tear of the acetabular labrum.
Most recently, the authors involved in this study performed a retrospective investigation (unpublished data) to capture patients with clinically and radiographically confirmed acetabular labral pathology electing to undergo conservative management defined as the refusal of surgical intervention. Based on a retrospective review of 894 patients presenting to clinic over a 10-year period, the investigators identified 22 patients with labral pathology that were treated non-operatively. Retrospective case control analysis was performed using outcome questionnaires administered to both surgical and non-surgical cohorts. The investigators found that patients with labral tears managed non-operatively appear to score highly on hip function outcome scores, preliminarily indicating there may be some benefit in using conservative management alone in the treatment of labral pathology.
This is a 12-month prospective randomized control trial (RCT), which will enroll 121 subjects with evidence consistent with a tear of the acetabular labrum. Labral tear will be diagnosed by clinical exam and positive MRI findings. Subjects will receive conservative physical therapy treatment alone or arthroscopic surgical labral repair and physical therapy. The investigators anticipate that pain, range of motion, activity level, and functional performance, as judged by validated outcome measures and serial physical exams, will improve when compared to baseline. The investigators also anticipate that the level of response will be greater in the surgical treatment group than in the physical therapy group at 12 months.
Our Primary Outcome is change in the modified Harris Hip Score at 12 months. Secondary outcomes include changes in other outcomes measures (LEFS, HOS, NAHS, iHOT-33), patient satisfaction, degree of improvement on physical exam, longer-term functional outcomes (i.e., at 2, 5, and 10 years), and the influence of OA severity (Outerbridge scoring) and location on the aforementioned outcome measures.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hip Arthroscopy Surgery with Acetabular Labral Repair | Active Comparator | Hip Arthroscopy Surgery with Acetabular Labral Repair |
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| Physical Therapy Focused on the Hip and Hemi-pelvis | Active Comparator | Physical Therapy focusing on the hemipelvis strengthening, including the lower back, lower abdominal core, quadriceps, hamstrings, and gluteal muscles. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hip Arthroscopy Surgery with Acetabular Labral Repair (SPT group) | Procedure | Patients randomized to the SPT group provided consent for arthroscopic acetabular labral repair with femoroacetabular osteoplasty. As previously described in various technique publications from our group, the senior surgeon's (S.D.M.) hip arthroscopy technique includes intra-articular fluid distension for initial portal placement, puncture capsulotomy, autograft capsular augmentation if insufficient or degenerative labral tissue is encountered, intermittent traction, sparing use of electrocautery, and preservation of the chrondrolabral junction. All SPT patients underwent a standardized postoperative physical therapy protocol developed jointly by the senior author (a sports medicine fellowship-trained orthopaedic surgeon) and the physical therapists. Patients were kept weightbearing as tolerated on crutches for 6 weeks to maintain a level pelvis without lurching when walking and were instructed to avoid impact loading exercises for 6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in mHHS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: modified Harris Hip Score (mHHS) Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of mHHS: Min: 0 Max: 100 Higher score indicates better hip functionally. No subscores or subscales. The mean changes in scores required to achieve a minimically clinically important difference is 6.9. | Baseline (pre-operative), 3 months, 6 months, 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change HOS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: HOS--Hip Outcome Score. Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of HOS: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. The mean change in HOS score required to achieve a minimally clinically important difference is 8.8. |
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Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Scott D Martin, MD | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| MGH, Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23104610 | Background | Register B, Pennock AT, Ho CP, Strickland CD, Lawand A, Philippon MJ. Prevalence of abnormal hip findings in asymptomatic participants: a prospective, blinded study. Am J Sports Med. 2012 Dec;40(12):2720-4. doi: 10.1177/0363546512462124. Epub 2012 Oct 25. | |
| 23326991 | Background | Vawklang N, Lertwanich P. Prevalence of acetabular labral tears and sublabral sulci: a cadaveric study. J Med Assoc Thai. 2012 Sep;95 Suppl 9:S104-9. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Hip Arthroscopy Surgery With Acetabular Labral Repair | Hip Arthroscopy Surgery with Acetabular Labral Repair Hip Arthroscopy Surgery with Acetabular Labral Repair: The research coordinator will, perform a baseline assessment, and randomize the patients into the study at this visit. Randomization will be assigned utilizing an electronic randomization program. Patients are prospectively identified and randomized into one of two study arms: arthroscopic surgery (AS) or physical therapy (PT). A third study arm, dependent upon improvement with PT, was created as patients crossed over (CO) from PT to AS after a lack of improvement after a minimum of 8 weeks of PT. AS consisted of labral repair. Any subject randomized to surgery will be seen by Dr. Martin to be consented separately for the arthroscopic procedure, which is standard of care. Those receiving surgical management will be scheduled for the post-operative physical therapy protocol within 2 weeks of their operative date, once a surgical date has been scheduled. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP_ICF | Yes | Yes | Yes | Study Protocol, Statistical Analysis Plan, and Informed Consent Form | Feb 5, 2021 |
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| Physical Therapy Focused on the Hip and Hemi-pelvis (PT group) | Procedure | PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week). |
|
| Baseline (pre-operative), 3 months, 6 months, 12 months |
| Change NAHS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: Non-Arthritic Hip Score (NAHS) Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery: Scale of NAHS: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. No subscores or subscales. No specific score to indicate a minimally clinically important difference. | Baseline (pre-operative), 3 months, 6 months, 12 months |
| Change iHOT--33 Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: International Hip Outcome Tool--33 Questions Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of iHOT-33: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. No subscores or subscales The mean changes in iHOT-33 scores required to achieve minimally clinically important difference is 15.1. | Baseline (pre-operative), 3 months, 6 months, 12 months |
| Change LEFS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: Lower Extremity Functional Scale (LEFS) Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of LEFS: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. There is no designated improvement that is deemed to be a minimally clinically important difference | Baseline (pre-operative), 3 months, 6 months, 12 months |
| Degree of Improvement on Hip VAS Pain Score | At routine follow-up visits patients will be asked to rate hip pain using the VAS (Visual Analog Scale) Score Min: 0--no pain Max: 10--worst pain experienced in their life Increments of 1. Categories: 1--3: mild pain 4--6: moderate pain 7--10: severe pain There is no reduction in VAS score that is considered a minimally clinically important difference. | Baseline (pre-operative), 3 months, 6 months, 12 months |
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| 39101607 | Derived | Martin SD, Dean MC, Gillinov SM, Cherian NJ, Eberlin CT, Kucharik MP, Abraham PF, Nazal MR, Conaway WK, Quinlan NJ, Alpaugh K, Torabian KA. Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: 24-Month Results From a Randomized Controlled Trial. Am J Sports Med. 2024 Aug;52(10):2574-2585. doi: 10.1177/03635465241263595. Epub 2024 Aug 5. |
| 33656950 | Derived | Martin SD, Abraham PF, Varady NH, Nazal MR, Conaway W, Quinlan NJ, Alpaugh K. Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: A Randomized Controlled Trial. Am J Sports Med. 2021 Apr;49(5):1199-1208. doi: 10.1177/0363546521990789. Epub 2021 Mar 3. |
| FG001 | Physical Therapy Focused on the Hip and Hemi-pelvis | Physical Therapy focusing on the hemipelvis strengthening, including the lower back, lower abdominal core, quadriceps, hamstrings, and gluteal muscles. Physical Therapy Focused on the Hip and Hemi-pelvis: The research coordinator will, perform a baseline assessment, and randomize the patients into the study at this visit. Randomization will be assigned utilizing an electronic randomization program. Patients are prospectively identified and randomized into one of two study arms: arthroscopic surgery (AS) or physical therapy (PT). A third study arm, dependent upon improvement with PT, was created as patients crossed over (CO) from PT to AS after a lack of improvement after a minimum of 8 weeks of PT. AS consisted of labral repair or debridement, if repair was not possible, and PT consisted of a uniform, comprehensive PT protocol guided by selected physical therapists. Those randomized to the physical therapy side will be referred to PT. Those receiving conservative management will be scheduled for physical therapy. |
| COMPLETED |
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| NOT COMPLETED |
|
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | SPT Group: Surgery and Physical Therapy | Patients randomized to the SPT group provided consent for arthroscopic acetabular labral repair with femoroacetabular osteoplasty. As previously described in various technique publications from our group, the senior surgeon's (S.D.M.) hip arthroscopy technique includes intra-articular fluid distension for initial portal placement,2 puncture capsulotomy,9 autograft capsular augmentation if insufficient or degenerative labral tissue is encountered,28,30 intermittent traction,37 sparing use of electrocautery,24 and preservation of the chrondrolabral junction.39 All SPT patients underwent a standardized postoperative physical therapy protocol developed jointly by the senior author (a sports medicine fellowship-trained orthopaedic surgeon) and the physical therapists. Patients were kept weightbearing as tolerated on crutches for 6 weeks to maintain a level pelvis without lurching when walking and were instructed to avoid impact loading exercises for 6 months. Appendix A (available in the online version of this article) provides the complete postoperative physical therapy protocol. |
| BG001 | PTA Group: Physical Therapy Alone | PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week. Appendix B (available online) provides the complete 24- week PT protocol assigned to PTA patients. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| ||||||||||||||||||
| Age, Continuous | Mean | Full Range | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||||
| Region of Enrollment | Number | participants |
| ||||||||||||||||||
| Radiographic Osteoarthritis | Tonnis grading is used to evaluate the extent of hip osteoarthritis seen on a plain anterior-posterior radiograph. Radiographs were graded by fellowship trained musculoskeletal radiologists. The scale is from 0-3 and is shown below. 0: no signs of osteoarthritis
| Mean | Inter-Quartile Range | units on a scale |
| ||||||||||||||||
| Body Mass Index | Mean | Inter-Quartile Range | kg/m^2 |
| |||||||||||||||||
| modified Harris Hip Score | The modified Harris Hip Scale (mHHS) was developed for the assessment of the results of hip surgery, and is intended to evaluate various hip disabilities and methods of treatment in an adult population. It features a series of questions that are subjectively completed by the patient, which provides a value output (higher score = better result). The interpretation of outcome using the modified Harris hip score was as follows: <70 (poor result), 70-79 (fair result), 80-89 (good result) and >90 (excellent result). | Mean | Inter-Quartile Range | units on a scale |
| ||||||||||||||||
| VAS Pain Score | The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between "no pain" and "worst pain." Higher values = higher pain and worse outcome. Absolute values of pain on a 0-10 scale naturally grouped into three categories: 1-4 (mild pain), 5 or 6 (moderate pain) and 7-10 (severe pain). | Mean | Inter-Quartile Range | units on a scale |
| ||||||||||||||||
| International Hip Outcome Tool - 33 | The International Hip Outcome Tool (iHOT) was developed by Mohtadi et al as a means of assessing a patient's ability to return to an active lifestyle through obtaining subjective measures of symptoms, as well as determining emotional and social health status. The iHOT is comprised of 33 questions relating to: Symptoms and Functional Limitations, Sports and Recreational Activities, Job-Related Concerns, Social, Emotional, and Lifestyle Concerns. Higher scores = better function and less limitations. | Mean | Inter-Quartile Range | units on a scale |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in mHHS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: modified Harris Hip Score (mHHS) Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of mHHS: Min: 0 Max: 100 Higher score indicates better hip functionally. No subscores or subscales. The mean changes in scores required to achieve a minimically clinically important difference is 6.9. | Posted | Mean | 95% Confidence Interval | units on a scale | Baseline (pre-operative), 3 months, 6 months, 12 months |
|
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Change HOS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: HOS--Hip Outcome Score. Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of HOS: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. The mean change in HOS score required to achieve a minimally clinically important difference is 8.8. | Posted | Mean | 95% Confidence Interval | units on a scale | Baseline (pre-operative), 3 months, 6 months, 12 months |
| ||||||||||||||||||||||||||||||||||||||
| Secondary | Change NAHS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: Non-Arthritic Hip Score (NAHS) Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery: Scale of NAHS: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. No subscores or subscales. No specific score to indicate a minimally clinically important difference. | Posted | Mean | 95% Confidence Interval | units on a scale | Baseline (pre-operative), 3 months, 6 months, 12 months |
| ||||||||||||||||||||||||||||||||||||||
| Secondary | Change iHOT--33 Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: International Hip Outcome Tool--33 Questions Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of iHOT-33: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. No subscores or subscales The mean changes in iHOT-33 scores required to achieve minimally clinically important difference is 15.1. | Posted | Mean | 95% Confidence Interval | units on a scale | Baseline (pre-operative), 3 months, 6 months, 12 months |
| ||||||||||||||||||||||||||||||||||||||
| Secondary | Change LEFS Surveys From Preoperative to Various Postoperative Timepoints | Full Name of Outcome: Lower Extremity Functional Scale (LEFS) Purpose: Validated Hip Patient Reported Outcome Measurements (PROMs) to assess the patient's functional outcomes post-surgery. Scale of LEFS: Min: 0 Max: 100 No standardized scoring categories (i.e. excellent, good, fair, poor). Higher score indicates better hip functionally. There is no designated improvement that is deemed to be a minimally clinically important difference | Posted | Mean | 95% Confidence Interval | units on a scale | Baseline (pre-operative), 3 months, 6 months, 12 months |
| ||||||||||||||||||||||||||||||||||||||
| Secondary | Degree of Improvement on Hip VAS Pain Score | At routine follow-up visits patients will be asked to rate hip pain using the VAS (Visual Analog Scale) Score Min: 0--no pain Max: 10--worst pain experienced in their life Increments of 1. Categories: 1--3: mild pain 4--6: moderate pain 7--10: severe pain There is no reduction in VAS score that is considered a minimally clinically important difference. | Posted | Mean | 95% Confidence Interval | units on a scale | Baseline (pre-operative), 3 months, 6 months, 12 months |
|
2 years. Each patient is followed clinically by the provider for 2 years from the time of enrollment into the study.
The definitions do not differ.
Not provided
| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | SPT Group: Surgery and Physical Therapy | Patients randomized to the SPT group provided consent for arthroscopic acetabular labral repair with femoroacetabular osteoplasty. As previously described in various technique publications from our group, the senior surgeon's (S.D.M.) hip arthroscopy technique includes intra-articular fluid distension for initial portal placement, puncture capsulotomy, autograft capsular augmentation if insufficient or degenerative labral tissue is encountered, intermittent traction, sparing use of electrocautery, and preservation of the chrondrolabral junction. All SPT patients underwent a standardized postoperative physical therapy protocol developed jointly by the senior author (a sports medicine fellowship-trained orthopaedic surgeon) and the physical therapists. Patients were kept weightbearing as tolerated on crutches for 6 weeks to maintain a level pelvis without lurching when walking and were instructed to avoid impact loading exercises for 6 months. | 0 | 46 | 0 | 46 | 0 | 46 |
| EG001 | PTA Group: Physical Therapy Alone. | PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week. Appendix B (available online) provides the complete 24- week PT protocol assigned to PTA patients. | 0 | 44 | 0 | 44 | 0 | 44 |
Not provided
Not provided
Crossover rates in this study were high. For ethical reasons, all randomized patients had to meet surgical eligibility, potentially increasing crossover rates because participants randomized to PTA were aware that they met surgical eligibility. Second, some patients may have had bias for either SPT or PTA. However, to minimize this bias, we imposed strict inclusion criteria to ensure that patients did not prefer one treatment arm and were fully committed to completing their assigned treatment.
Not provided
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Scott Martin | Massachusetts General Hospital | (617) 726-7500 | sdmartin@partners.org |
| Mar 3, 2021 |
| Prot_SAP_ICF_000.pdf |
| ID | Term |
|---|---|
| D057925 | Femoracetabular Impingement |
| D015207 | Osteoarthritis, Hip |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001168 | Arthritis |
| D012216 | Rheumatic Diseases |
Not provided
Not provided
| >=65 years |
|
| Male |
|
| Asian |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| mHHS improvement 12 months |
|
| OG001 |
| Physical Therapy Focused on the Hip and Hemi-pelvis |
Physical Therapy focusing on the hemipelvis strengthening, including the lower back, lower abdominal core, quadriceps, hamstrings, and gluteal muscles. Physical Therapy Focused on the Hip and Hemi-pelvis: The research coordinator will, perform a baseline assessment, and randomize the patients into the study at this visit. Randomization will be assigned utilizing an electronic randomization program. Patients are prospectively identified and randomized into one of two study arms: arthroscopic surgery (AS) or physical therapy (PT). A third study arm, dependent upon improvement with PT, was created as patients crossed over (CO) from PT to AS after a lack of improvement after a minimum of 8 weeks of PT. AS consisted of labral repair or debridement, if repair was not possible, and PT consisted of a uniform, comprehensive PT protocol guided by selected physical therapists. Those randomized to the physical therapy side will be referred to PT. Those receiving conservative management will be scheduled for physical therapy. |
|
|
| OG001 | PTA Group: Physical Therapy Alone Group | PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week. Appendix B (available online) provides the complete 24- week PT protocol assigned to PTA patients. |
|
|
| OG001 | PTA Group: Physical Therapy Alone Group | PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week. Appendix B (available online) provides the complete 24- week PT protocol assigned to PTA patients. |
|
|
| OG001 | PTA Group: Physical Therapy Alone Group | PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week. Appendix B (available online) provides the complete 24- week PT protocol assigned to PTA patients. |
|
|
| OG001 |
| PTA Group: Physical Therapy Alone Group |
PTA patients were assigned a standardized, 24-week course of supervised, core-based PT. This course was designed in concert with physical therapists within our institution to help address symptoms of labral tear in patients older than 40 who had mild to moderate OA. Weeks 1 and 2 focused on normalizing gait, and weeks 3 through 24 focused on optimizing range of motion (ROM) while slowly integrating strength training. Unlike the prerandomization PT protocol, the PTA protocol was predominantly physical therapist-supervised (at least 1 in-person visit per week. Appendix B (available online) provides the complete 24- week PT protocol assigned to PTA patients. |
|
|