Dijkstra H Paul, Mc Auliffe Sean, Ardern Clare L, Kemp Joanne L, Mosler Andrea Britt, Price Amy, Blazey Paul, Richards Dawn, Farooq Abdulaziz, Serner Andreas, McNally Eugene, Mascarenhas Vasco, Willy Richard W, Oke Jason L, Khan Karim M, Glyn-Jones Sion, Clarke Mike, Greenhalgh Trisha
Department of Medical Education, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
Department for Continuing Education, University of Oxford, Oxford, UK.
Br J Sports Med. 2022 Dec 6;57(6):342-58. doi: 10.1136/bjsports-2022-106092.
Primary cam morphology is highly prevalent in many athlete populations, causing debilitating hip osteoarthritis in some. Existing research is mired in confusion partly because stakeholders have not agreed on key primary cam morphology elements or a prioritised research agenda. We aimed to inform a more rigorous, inclusive and evidence-based approach to research on primary cam morphology and its natural history by working towards agreement on a set of research priorities for conditions affecting the young person's hip.
An international expert panel-the Young Athlete's Hip Research (YAHiR) Collaborative-rated research priority statements through an online two-round Delphi exercise and met online to explore areas of tension and dissent. Panellists ranked the prioritised research statements according to the Essential National Health Research (ENHR) ranking strategy. Reporting of results followed REPRISE (REporting guideline for PRIority SEtting of health).
A diverse Delphi panel (n=65, Delphi rounds 1 and 2; three ENHR strategy surveys: n=49; n=44; n=42) from 18 countries representing six stakeholder groups, prioritised and ranked 18 of 38 research priority statements. The prioritised statements outlined seven research domains: (1) best practice physiotherapy, (2) rehabilitation progression and return to sport, (3) exercise intervention and load management, (4) primary cam morphology prognosis and aetiology, (5) femoroacetabular impingement syndrome prognosis and aetiology, (6) diagnostic criteria, and (7) screening. The panel recommended areas of tension and dissent for the research community to focus on immediately.
While informing more rigorous, inclusive and evidence-based research, this consensus is a roadmap for researchers, policy-makers and funders to implement research dedicated to reducing the cost and burden of hip disease related to primary cam morphology.
原发性凸轮形态在许多运动员群体中极为普遍，在某些情况下会导致使人衰弱的髋骨关节炎。现有研究陷入混乱，部分原因是利益相关者尚未就原发性凸轮形态的关键要素或优先研究议程达成一致。我们旨在通过就影响年轻人髋关节的一系列研究重点达成共识，为原发性凸轮形态及其自然史的研究提供一种更严谨、更具包容性且基于证据的方法。
一个国际专家小组——青年运动员髋关节研究（YAHiR）协作组，通过两轮在线德尔菲法对研究重点声明进行评分，并在线开会探讨存在分歧和争议的领域。小组成员根据基本国家卫生研究（ENHR）排名策略对优先研究声明进行排序。结果报告遵循REPRISE（卫生优先事项设定报告指南）。
一个来自18个国家、代表六个利益相关者群体的多元化德尔菲小组（第一轮和第二轮德尔菲法有65人；三项ENHR策略调查分别有49人、44人、42人），对38项研究重点声明中的18项进行了优先排序和排名。优先声明概述了七个研究领域：（1）最佳物理治疗实践，（2）康复进展和恢复运动，（3）运动干预和负荷管理，（4）原发性凸轮形态的预后和病因，（5）股骨髋臼撞击综合征的预后和病因，（6）诊断标准，以及（7）筛查。该小组推荐了一些存在分歧和争议的领域，供研究界立即关注。
在为更严谨、更具包容性且基于证据的研究提供信息的同时，这一共识为研究人员、政策制定者和资助者实施旨在降低与原发性凸轮形态相关的髋部疾病成本和负担的研究提供了路线图。
