Pain Injections for Hip Arthroscopy Patients May Not Predict Surgical Outcomes

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How best to treat and recover from complicated hip injuries is a growing field in orthopaedic medicine. While diagnostic hip injections are commonly performed for patients with labral tear to confirm the pain etiology, research presented today at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day suggests that pain relief from this diagnostic injection may not predict better outcomes following arthroscopic hip surgery.

We believe that careful evaluation of the patient and correlation of presenting symptoms, physical examination, and imaging findings are the most important factors in considering patients for surgery," Aaron Krych, MD

How best to treat and recover from complicated hip injuries is a growing field in orthopaedic medicine. While diagnostic hip injections are commonly performed for patients with labral tear to confirm the pain etiology, research presented today at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day suggests that pain relief from this diagnostic injection may not predict better outcomes following arthroscopic hip surgery.

“Our study looked to assess if the amount of pain relief from a preoperative diagnostic intra-articular (IA) injection correlated with patient outcomes following surgery of an individual with femoracetabular impingement (FAI). However, our data indicated that the amount of pain relief from an IA injection is a poor predictor of short-term positive outcomes at our institution,” said lead author, Aaron Krych, MD of the Mayo Clinic in Rochester, MN.

Krych and his team analyzed records of patients who were undergoing hip arthroscopy for FAI from 2007-2012. Pre-operative radiographs were reviewed along with degree of osteoarthritis. Ninety-six patients met the study’s inclusion criteria, including 71 females and 25 males with an average age of 37.5 years that were followed prospectively. There was no significant difference in the outcome scores for individuals with greater than 50 percent pain relief compared to patients that had less than 50 percent pain relief on preoperative diagnostic injection. Even with an adjustment for chondral degeneration and arthritis, the difference in pain relief and outcomes was minimal.

“Looking at different ways to treat hip pain and improve patient selection for surgery is a critical part of orthopaedic medicine. Even though our study did not show any significant improvements in outcomes, it does highlight the need for future investigations of what might be increase success,” said Krych. “While there are no current absolute indications for FAI surgery, we believe that careful evaluation of the patient and correlation of presenting symptoms, physical examination, and imaging findings are the most important factors in considering patients for surgery.”

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The American Orthopaedic Society for Sports Medicine (AOSSM) is a world leader in sports medicine education, research, communication and fellowship, and includes national and international orthopaedic sports medicine leaders. The Society works closely with many other sports medicine specialists, including athletic trainers, physical therapists, family physicians, and others to improve the identification, prevention, treatment, and rehabilitation of sports injuries. AOSSM is also a founding partner of the STOP Sports Injuries campaign to prevent overuse and traumatic injuries in kids. For more information on AOSSM or the STOP Sports Injuries campaign, visit http://www.sportsmed.org or http://www.stopsportsinjuries.org

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Lisa Weisenberger
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