Journal article
Best Practice Guidelines for Hip Arthroscopy in Femoroacetabular Impingement: Results of a Delphi Process
Journal of the American Academy of Orthopaedic Surgeons, Vol.28(2), pp.81-89
01/15/2020
DOI: 10.5435/JAAOS-D-18-00041
PMID: 31181030
Abstract
Background: Treatment algorithms for the arthroscopic management of femoroacetabular impingement (FAI) syndrome remain controversial because of a paucity of evidence-based guidance. Consequently, notable variability in clinical practice exists between different practitioners, necessitating expert consensus. The purpose of this study is to establish best practice guidelines (BPG) using formal techniques of consensus building among a group of experienced hip arthroscopists driven by the results of a systematic review and meta-analysis. The scope of these guidelines includes preoperative recommendations, intraoperative practices, and postoperative protocols. Methods: The validated Delphi process and the nominal group technique (NGT), used by the Centers for Disease Control and Prevention and the peer-reviewed orthopaedic literature, were used to formally derive consensus among 15 surgeons in North America. Participants were surveyed for current practices, presented with the results of a meta-analysis and systematic literature review, and asked to vote for or against the inclusion of nonleading, impartially phrased items during three iterative rounds while preserving the anonymity of participants' opinions. Agreement greater than 80% was considered consensus, and items near consensus (70% to 80% agreement) were further queried using the NGT in a moderated group session at the American Orthopaedic Society for Sports Medicine annual meeting. Results: Participants had a mean of 12.3 years of practice (range: 1 to 29 years) and performed an annual mean of 249 (range 100 to 500+) hip arthroscopies, with a combined total of approximately 52,580 procedures. Consensus was reached for the creation of BPG consisting of 27 preoperative recommendations, 15 intraoperative practices, and 10 postoperative protocols. The final checklist was supported by 100% of participants. Conclusion: We developed the first national consensus-based BPG for the surgical and nonsurgical management of FAI. The resulting consensus items can serve as a tool to reduce the variability in preoperative, intraoperative, and postoperative practices and guide further research for the arthroscopic management of FAI.
Details
- Title: Subtitle
- Best Practice Guidelines for Hip Arthroscopy in Femoroacetabular Impingement: Results of a Delphi Process
- Creators
- T. Sean Lynch - Columbia University Medical CenterAnas Minkara - Cleveland Clin, Dept Orthopaed Surg, Cleveland, OH 44106 USAStephen Aoki - Univ Utah, Dept Orthoped, Salt Lake City, UT USAAsheesh Bedi - Univ Michigan, Dept Orthoped, Ann Arbor, MI 48109 USASrino Bharam - Lenox Hill Hosp, Dept Orthopaed, New York, NY 10021 USAJohn Clohisy - Orthopaedic SurgeryJoshua Harris - Houston MethodistChristopher Larson - Twin Cities Orthoped, Minneapolis, MN USAJeffrey Nepple - Orthopaedic SurgeryShane Nho - Midwest Orthopaed Rush, Chicago, IL USAMarc Philippon - Steadman Clin, Vail, CO USAJames Rosneck - Cleveland Clin, Dept Orthopaed Surg, Cleveland, OH 44106 USAMarc Safran - Stanford Univ, Dept Orthopaed Surg, Stanford, CA 94305 USAAllston J. Stubbs - Wake Forrest Univ, Bowman Gray Sch Med, Dept Orthopaed, Winston Salem, NC USARobert Westermann - Univ Iowa Hosp, Dept Orthoped, Iowa City, IA USAJ. W. Thomas Byrd - Nashville Hip Inst, Nashville, TN USA
- Resource Type
- Journal article
- Publication Details
- Journal of the American Academy of Orthopaedic Surgeons, Vol.28(2), pp.81-89
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.5435/JAAOS-D-18-00041
- PMID
- 31181030
- ISSN
- 1067-151X
- eISSN
- 1940-5480
- Number of pages
- 9
- Language
- English
- Date published
- 01/15/2020
- Academic Unit
- Orthopedics and Rehabilitation; Athletic Training Program
- Record Identifier
- 9984304722202771
Metrics
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