2012 AAOS Femoroacetabular Impingement Research Symposium

描述（由申请人提供）：骨关节炎（OA）影响了大约30%的60岁以上的美国人，是骨科患者生活质量下降和功能丧失的主要原因之一。下肢骨性关节炎尤其常见且费用昂贵。据估计，到2030年，美国每年将进行超过440万例髋关节和膝关节置换术，髋关节置换术的数量将增加200%。需要创新的策略来更有效地诊断、预防和治疗OA。未来的治疗创新将集中于疾病的早期检测和治疗干预，以预防或阻止疾病进展并保护自然髋关节。在过去的十年中，在阐明髋关节骨关节炎的病理生理方面取得了重大进展。最重要的是，股髋臼撞击（FAI）的深刻病因学作用已经来到了最前沿。FAI的特征是股骨近端和髋臼的结构畸形，沿髋臼边缘产生异常的重复基台，导致过度负荷，髋臼边缘软骨损伤和进行性关节退变。FAI患者存在于不同的年龄和不同的疾病阶段。由于患者群体的异质性和疾病特征的可变性，FAI的治疗涉及各种肌肉骨骼医疗保健提供者，包括矫形外科医生（成人重建，儿科，运动和创伤），风湿病学家，理疗师，物理治疗师和初级保健医生。尽管最近对FAI的手术治疗有了兴趣和技术创新，但在这一新兴领域仍需要进行基础和临床研究。此外，FAI在髋关节OA中的病因学作用、FAI的自然史、FAI的病理生理学、最佳诊断和疾病分期方式、不同治疗技术的疗效、最合适的临床结果测量和未来临床试验的最佳研究设计等方面仍存在重大争议。在这些问题上增进共识将为今后的基础科学研究、临床试验和改进临床证据以指导患者治疗提供基础。治疗FAI的进展取决于对疾病病理生理学的更好理解，以及确定不同治疗干预措施的临床疗效和经济价值。2012年AAOS股髋臼撞击研究研讨会将强调多学科方法，并将重点总结当前的知识，形成共识，并确定与FAI相关的几个关键问题的研究策略。重点议题将包括：1)髋关节骨关节炎的病因、流行病学和社会影响；2) FAI在髋关节OA病理生理中的作用；3) FAI的基础科学；4) FAI疾病筛查、诊断和疾病分期；5)不同治疗方式和最佳临床科学方法的相对疗效和结果；6)未来基础和临床研究的策略。

DESCRIPTION (provided by applicant): Osteoarthritis (OA) affects an estimated 30% of Americans over 60 years of age and is one of the leading causes of reduced quality of life and loss of function for orthopaedic patients. Lower extremity OA is particularly common and costly. Estimates show that by 2030, over 4.4 million hip and knee replacement procedures will be performed annually in the United States with the number of hip replacements increasing by 200%. Innovative strategies are needed to more effectively diagnose, prevent and treat OA. Future treatment innovations will focus on early detection of disease and therapeutic interventions to prevent or halt disease progression and preserve the natural hip joint. Over the past decade there have been major advances in elucidating the pathophysiology of hip osteoarthritis. Most importantly, the profound etiological role of femoroacetabular impingement (FAI) has come to the forefront. FAI is characterized by structural deformities of the proximal femur and acetabulum that produce abnormal repetitive abutment along the acetabular rim resulting in excessive loading, acetabular rim cartilage damage and progressive joint degeneration. Patients with FAI present at various ages with diverse stages of disease. Due to the heterogeneous patient population and variability of disease characteristics, treatment of FAI encompasses a variety of musculoskeletal healthcare providers including orthopaedic surgeons (adult reconstruction, pediatrics, sports and trauma), rheumatologists, physiatrists, physical therapists and primary care physicians. Despite the recent interest and technical innovations for the surgical treatment of FAI, there is a major need for basic and clinical investigation in this burgeoning field. Additionally, significant controversy persists regarding the etiologic role of FAI in hip OA, the natural history of FAI, the pathophysiology of FAI, optimal diagnostic and disease staging modalities, the efficacy of different treatment techniques, and the most appropriate clinical outcome measures and optimal study designs for future clinical trials. Improved consensus regarding these issues will provide a foundation for future basic science investigations, clinical trials and improved clinical evidence to guide patient treatment. Advances in treating FAI are dependent upon improved understanding of the disease pathophysiology and determining the clinical efficacy and economic value of distinct treatment interventions. The 2012 AAOS Femoroacetabular Impingement research symposium will emphasize a multidisciplinary approach and will focus on summarizing current knowledge, developing consensus and identifying research strategies for several key issues related to FAI. Focus topics will include: 1) The etiology, epidemiology and societal impact of hip OA; 2) The role of FAI in hip OA pathophysiology; 3) The basic science of FAI; 4) FAI disease screening, diagnostics, and disease staging; 5) The relative effectiveness and outcomes of different treatment modalities and optimal clinical science methodologies; and 6) Strategies for future basic and clinical investigations. PUBLIC HEALTH RELEVANCE: Osteoarthritis (OA) affects an estimated 30% of Americans over 60 years of age and is one of the leading causes of reduced quality of life and loss of function for orthopaedic patients. Lower extremity OA is particularly common and costly. Estimates show that by 2030 over 4.4 million hip and knee replacement procedures will be performed annually in the United States with the number of hip replacements increasing by 200%. Femoroacetabular impingement (FAI) has recently come to the forefront as a potential precursor to hip osteoarthritis. There is a major need for improved consensus regarding the definition, diagnosis, treatment and etiological role of FAI relative to hip OA.