Childs Sean, McVicker Zachary, Trombetta Ryan, Awad Hani, Elfar John, Giordano Brian
Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, New York, USA.
Orthop J Sports Med. 2018 Sep 11;6(9):2325967118794645. doi: 10.1177/2325967118794645. eCollection 2018 Sep.
Femoroacetabular impingement (FAI) represents complex alterations in the bony morphology of the proximal femur and acetabulum. Imaging studies have become crucial in diagnosis and treatment planning for symptomatic FAI but also have limited patient understanding and satisfaction. Exploration of alternative patient counseling modalities holds promise for improved patient understanding, satisfaction, and ultimately for outcomes.
To compare perceived understanding of functional anatomy and FAI pathomorphology among patients counseled with routine computed tomography (CT), generic hip models, and a 3-dimensional (3D) model printed in accordance with a patient's specific anatomy.
Cohort study; Level of evidence, 2.
A prospective randomized analysis of patients presenting with radiographically confirmed FAI was conducted between November 2015 and April 2017. Patients were randomized into groups that received preoperative counseling with CT imaging alone, a generic human hip model, or a haptic 3D model of their hip. All groups were subjected to a novel questionnaire examining patient satisfaction and understanding on a variety of topics related to FAI. Data were compared with bivariate and multivariate analyses. Statistical significance was determined as < .05.
Thirty-one patients were included in this study (25 men, 6 women). Ten patients were randomized to the CT-only group, 11 to the generic hip model group, and 10 to receive custom 3D-printed models of their hips. Patients preoperatively counseled with isolated CT imaging or a generic hip model reported greater understanding of their pathophysiology and the role of surgical intervention when compared with those counseled with haptic 3D models ( = .03). At final follow-up, patients counseled with the use of isolated CT imaging or haptic 3D models reported greater increases and retention of understanding as compared with those counseled with generic hip models alone ( = .03).
Preoperative counseling with haptic 3D hip models does not appear to favorably affect patient-reported understanding or satisfaction with regard to FAI when compared with the use of CT imaging alone. Continued research into alternative counseling means may serve to further improve patient understanding and satisfaction on this complex anatomic phenomenon.
股骨髋臼撞击症（FAI）表现为股骨近端和髋臼骨形态的复杂改变。影像学研究对于有症状的FAI的诊断和治疗规划至关重要，但患者的理解和满意度有限。探索替代的患者咨询方式有望提高患者的理解、满意度，并最终改善治疗结果。
比较接受常规计算机断层扫描（CT）、通用髋关节模型以及根据患者特定解剖结构打印的三维（3D）模型咨询的患者对功能解剖和FAI病理形态的认知理解。
队列研究；证据等级，2级。
在2015年11月至2017年4月期间，对经影像学证实患有FAI的患者进行前瞻性随机分析。患者被随机分为三组，分别接受单独的CT成像术前咨询、通用人体髋关节模型咨询或其髋关节的触觉3D模型咨询。所有组均接受一份新颖的问卷，调查患者对与FAI相关的各种主题的满意度和理解程度。数据通过双变量和多变量分析进行比较。统计学显著性确定为P <.05。
本研究共纳入31例患者（25例男性，6例女性）。10例患者被随机分配到仅接受CT组，11例到通用髋关节模型组，10例接受其髋关节的定制3D打印模型组。与接受触觉3D模型咨询的患者相比，接受单独CT成像或通用髋关节模型术前咨询的患者报告对其病理生理学和手术干预作用有更好的理解（P =.03）。在最终随访时，与仅接受通用髋关节模型咨询的患者相比，接受单独CT成像或触觉3D模型咨询的患者报告理解程度有更大的提高和保持（P =.03）。
与单独使用CT成像相比，使用触觉3D髋关节模型进行术前咨询似乎对患者报告的对FAI的理解或满意度没有产生有利影响。对替代咨询方式的持续研究可能有助于进一步提高患者对这种复杂解剖现象的理解和满意度。
