9 of 12 Top Hip Papers of 2024 | FAIS to hip OA within 10 years
Welcome back to my 12 Top Hip Papers of 2024 series of miniblogs, where I walk you through what has been happening in the hip world over 2024. We are now at Day 9! If you missed day 8, you'll find a link at the bottom of this page to take you back. On day 9 we'll be taking a look at a paper that revealed the strong association between FAIS in middle-aged individuals and developing hip OA within 10 years.
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9 of 12 Top Hip Papers of 2024: FAIS in middle-aged individuals is strongly associated with developing hip OA within 10 years1
This Featured Hip Paper reported on the relationship between Femoroacetabular Impingement Syndrome in middle aged individuals and the development of radiographic hip osteoarthritis. Read on to find out more!
Background:
- Previous research has demonstrated that the presence of cam morphology on imaging is a risk factor for the development of hip pain and osteoarthritis.
- However, we haven't had information on the relationship between FAIS and hip OA - i.e., not just the cam shape, but the combination of cam morphology, symptoms and clinical signs (FAIS).
Study Aim:
- To determine the association and absolute risk that femoroacetabular impingement syndrome (FAIS) represents for the development of radiographic hip osteoarthritis.
What was done:
- This is a substudy of a large multicentre prospective cohort study of 1002 Dutch individuals - Cohort Hip and Cohort Knee (CHECK), with the overall objective to study the cause and course of osteoarthritis.
- This paper looked at the relationship between baseline FAIS (cam morphology, clinical signs and symptoms) and the development of radiographic hip osteoarthritis over 10 years.
- Note that the individuals were middle aged - mean age 55.7 years.
Key Findings:
- Of those middle-aged individuals who had FAIS at baseline:
- 81% had radiographic hip osteroarthritis by 10 years, and
- 33% had end-stage hip osteoarthritis or has undergone total hip replacement.
- The odds of having hip OA 10 years later, were 6.8 x greater for those who had FAIS at baseline.
Clinical Implications:
- The presence of cam morphology on imaging has previously been reported to increase the risks of developing hip osteoarthritis.
- This study shows that the combination of hip pain, limited hip internal rotation and cam morphology on imaging results in much greater absolute risk of developing hip osteoarthritis within 10 years, than cam morphology alone.
- Researchers and clinicians need to consider early intervention options.
Middle-aged people presenting with the combination of cam morphology, hip pain and restricted hip internal rotation (≤ 25°) had an almost 7x greater risk of developing hip osteoarthritis within 10 years, with 1 in 3 developing end-stage OA or undergoing THR in this time.
For both researchers and clinicians, this means we need to identify these high-risk individuals early and aim to provide best possible options to reduce the risk of developing hip OA. None of these patients had radiographic OA at baseline. Health professionals have an important opportunity and responsibility to act on this information.
Patient education is key, avoiding creating fear but empowering the patient to do something about this now. Load management is likely to be important and educating the patient around how to recognise and manage inflammatory flares, due to adverse effects inflammation has on chondral health. Then we need to provide a comprehensive and progressive exercise program, ensuring we address known risks of microinstability, optimise control of femoropelvic kinematics, and attend to individual impairments.
We need to help these at-risk patients find balance between retaining good activity levels, quality-of-life and optimal hip health. Further research is required to help guide clinicians determine the best options for reducing risks of developing hip osteoarthritis in those with FAIS.
Like to learn more about assessment and management of femoroacetabular impingement syndrome?
In this course, you can find detailed information on pathoaetiology, assessment and management of FAIS and many other joint, soft tissue and nerve related conditions. To learn more, take the anterior hip and groin pain online course, or join me in an online or practical anterior hip and groin pain workshop.
This online course is included in Hip Academy and Hip Academy members receive discounts for online workshops.
I hope you enjoyed the infographics and key learnings from Day 9 of my 12 Top Hip Papers of 2024. There are 3 more papers to come, so keep an eye out, to see what other top papers and infographics I have prepared for you!
Missed paper 8? Click above to read it!
Paper 10 comes out tomorrow!
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