Khan Moin, Ayeni Olufemi R, Madden Kim, Bedi Asheesh, Ranawat Anil, Kelly Bryan T, Sancheti Parag, Ejnisman Leandro, Tsiridis Eleftherios, Bhandari Mohit
Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Arthroscopy. 2016 May;32(5):779-787.e4. doi: 10.1016/j.arthro.2015.10.011. Epub 2016 Jan 14.
This international survey was conducted to assess the perceptions of orthopaedic surgeons regarding the diagnosis and management of femoroacetabular impingement (FAI) as well as to explore the current demographic characteristics of surgeons performing FAI surgery.
A survey was developed using previous literature, focus groups, and a sample-to-redundancy strategy. The survey contained 46 questions and was e-mailed to national orthopaedic associations and orthopaedic sports medicine societies for member responses. Members were contacted on multiple occasions to increase the response rate.
Nine hundred orthopaedic surgeons from 20 national and international organizations completed the survey. Surgeons responded across 6 continents, 58.2% from developed nations, with 35.4% having sports fellowship training. North American and European surgeons reported significantly greater exposure to hip arthroscopy during residency and fellowship training in comparison to international respondents (48.0% and 44.5% respectively, v 25.6%; P < .001). Surgeons performing a higher volume of FAI surgery (> 100 cases per year) were significantly more likely to have practiced for more than 20 years (odds ratio [OR], 1.91; 95% confidence interval [CI], 1.01 to 3.63), to be practicing at an academic hospital (OR, 2.25; 95% CI, 1.22 to 4.15), and to have formal arthroscopy training (OR, 46.17; 95% CI, 20.28 to 105.15). High-volume surgeons were over two-fold more likely to practice in North America and Europe (OR, 2.26; 95% CI, 1.08 to 4.72).
The exponential rise in the diagnosis and surgical management of FAI appears to be driven largely by experienced surgeons in developed nations. Significant variability exists regarding the diagnosis and management of FAI. Our analysis suggests that although FAI management is early in the innovation cycle, we are at a tipping point toward wider uptake and use.
开展这项国际调查，以评估骨科医生对股骨髋臼撞击症（FAI）诊断和治疗的看法，并探究目前开展FAI手术的外科医生的人口统计学特征。
利用既往文献、焦点小组及样本冗余策略制定了一项调查问卷。该问卷包含46个问题，并通过电子邮件发送给各国骨科协会和骨科运动医学学会，以供其成员作答。多次联系成员以提高回复率。
来自20个国家和国际组织的900名骨科医生完成了该调查。外科医生来自六大洲，58.2%来自发达国家，35.4%接受过运动医学专科培训。与国际受访者相比，北美和欧洲的外科医生报告称，在住院医师培训和专科培训期间接触髋关节镜检查的机会显著更多（分别为48.0%和44.5%，相比25.6%；P < 0.001）。每年开展FAI手术量较高（>100例）的外科医生更有可能已从业20多年（比值比[OR]，1.91；95%置信区间[CI]，1.01至3.63），在学术医院执业（OR，2.25；95%CI，1.22至4.15），并接受过正规的关节镜检查培训（OR，46.17；95%CI，20.28至105.15）。手术量高的外科医生在北美和欧洲执业的可能性高出两倍多（OR，2.26；95%CI，1.08至4.72）。
FAI诊断和手术治疗的迅速增加似乎主要由发达国家经验丰富的外科医生推动。FAI的诊断和治疗存在显著差异。我们的分析表明，尽管FAI治疗尚处于创新周期的早期，但我们正处于向更广泛采用和应用转变的临界点。
