Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Short-term Clinical Outcomes of Hip Arthroscopy Versus Physical Therapy in Patients With Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
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DOI：
10.1177/2325967120968490
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发表时间：
2020-11
影响因子：
2.6
通讯作者：
Nepple JJ
中科院分区：
文献类型：
--
作者：
Schwabe MT;Clohisy JC;Cheng AL;Pascual-Garrido C;Harris-Hayes M;Hunt DM;Harris MD;Prather H;Nepple JJ
物理治疗（PT）和手术治疗股骨髋臼撞击症（FAI）都是有效的，但其相对疗效直到最近才得到很好的证实。已经发表了几项比较这些治疗的早期临床结果的随机对照试验（RCT），结果相互矛盾。本研究的目的是对RCT进行荟萃分析，比较髋关节镜检查与PT在症状性FAI患者中的早期患者报告结局（PRO）。假设FAI的手术治疗比PT的短期结局更好。系统评价;证据等级，1。2019年3月，进行了一项系统性综述，以确定比较症状性FAI患者髋关节镜检查和PT的RCT。在6个数据库中共发现819项研究;其中3项RCT符合资格（Griffin et al，2018; Mansell et al，2018;和Palmer et al，2019）。所有3项RCT均报告了国际髋关节结局工具-33（iHOT-33）评分，2项报告了髋关节结局评分（HOS）-日常生活活动（ADL）和HOS-运动结果。在随机效应荟萃分析中，根据意向治疗和实际治疗方法评估干预后评分的组间差异。使用CONSORT、CERT、TiDieR和科克伦协作工具评估质量。3项随机对照试验包括650例FAI患者;平均随访时间为8 - 24个月。所有研究均报告了PT和手术从基线至随访的PRO改善。格里芬和帕尔默的研究质量很好，偏差很小。在Mansell研究中，从PT到手术的70%交叉率增加了偏倚风险。荟萃分析表明，与PT相比，意向治疗（平均差异[MD]，11.3; P = 0.046）和实际治疗（MD，12.6; P = 0.007）分析的iHOT-33结局有所改善。HOS-ADL评分的治疗荟萃分析支持手术（MD，12.0; P <0.001），而意向治疗分析显示两组HOS-ADL评分无显著差异（MD，3.9; P = 0.571）。在FAI患者中，3项RCT的综合结果表明，手术的短期结局上级PT。然而，PT确实改善了结局，并且似乎不会影响治疗失败和进展至手术的患者的手术结局。
Both physical therapy (PT) and surgery are effective in treating femoroacetabular impingement (FAI), but their relative efficacy has not been well established until recently. Several randomized controlled trials (RCTs) comparing the early clinical outcomes of these treatments have been published, with contradictory results. The purpose of this study was to perform a meta-analysis of RCTs that compared early patient-reported outcomes (PROs) of hip arthroscopy versus PT in patients with symptomatic FAI. The hypothesis was that surgical treatment of FAI leads to better short-term outcomes than PT. Systematic review; Level of evidence, 1. In March 2019, a systematic review was performed to identify RCTs comparing hip arthroscopy and PT in patients with symptomatic FAI. A total of 819 studies were found among 6 databases; of these, 3 RCTs met eligibility (Griffin et al, 2018; Mansell et al, 2018; and Palmer et al, 2019). All 3 RCTs reported international Hip Outcome Tool--33 (iHOT-33) scores, and 2 reported Hip Outcome Score (HOS)–Activities of Daily Living (ADL) and HOS-Sport results. In a random-effects meta-analysis, between-group differences in postintervention scores were assessed according to intention-to-treat and as-treated approaches. Quality was assessed with CONSORT, CERT, TiDieR, and the Cochrane Collaboration tool. The 3 RCTs included 650 patients with FAI; the mean follow-up ranged from 8 to 24 months. All studies reported PRO improvement from baseline to follow-up for both PT and surgery. The quality of the Griffin and Palmer studies was good, with minimal bias. In the Mansell study, a 70% crossover rate from PT to surgery increased the risk of bias. The meta-analysis demonstrated improved iHOT-33 outcomes with surgery compared with PT for intention-to-treat (mean difference [MD], 11.3; P = .046) and as-treated (MD, 12.6; P = .007) analyses. The as-treated meta-analysis of HOS-ADL scores favored surgery (MD, 12.0; P < .001), whereas the intention-to-treat analysis demonstrated no significant difference between groups for HOS-ADL (MD, 3.9; P = .571). In patients with FAI, the combined results of 3 RCTs demonstrated superior short-term outcomes for surgery versus PT. However, PT did result in improved outcomes and did not appear to compromise the surgical outcomes of patients for whom therapy failed and who progressed to surgery.
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影响因子：
4.6
作者：
Palmer, A. J. R.;Thomas, G. E. R.;Glyn-Jones, S.
通讯作者：
Glyn-Jones, S.
影响因子：
18.4
作者：
Wall PD;Dickenson EJ;Robinson D;Hughes I;Realpe A;Hobson R;Griffin DR;Foster NE
通讯作者：
Foster NE
DOI：
10.1016/j.jclinepi.2010.03.004
发表时间：
2010-01-01
期刊：
Open medicine : a peer-reviewed, independent, open-access journal
影响因子：
--
作者：
Schulz, Kenneth F;Altman, Douglas G;Moher, David
通讯作者：
Moher, David
DOI：
10.2519/jospt.2014.0302
发表时间：
2014-06-01
期刊：
The Journal of orthopaedic and sports physical therapy
影响因子：
--
作者：
Enseki, Keelan;Harris-Hayes, Marcie;Clohisy, John C
通讯作者：
Clohisy, John C
影响因子：
4.8
作者：
Frank, Rachel M.;Lee, Simon;Nho, Shane J.
通讯作者：
Nho, Shane J.