Kamaci Saygin, Goker Barlas, Bingol Izzet, Kolac Ulas Can, Yasar Niyazi Erdem, Fidanci Ali Aykut, Ata Naim, Ulgu M Mahir, Birinci Suayip, Kayaalp Asim, Beyzadeoglu Tahsin, Atilla Bulent, Kocaoglu Baris
Department of Orthopedic Surgery, Hacettepe University, Ankara, Türkiye, Turkey.
Department of Orthopedic Surgery, Montefiore Medical Center, New York, NY, USA.
Sci Rep. 2025 Jul 1;15(1):22030. doi: 10.1038/s41598-025-91956-3.
Diagnosing femoroacetabular impingement (FAI) is challenging and surgical indications for hip arthroscopy are still evolving. This study analyzes the two years leading up to surgery in a large cohort of patients with FAI. We hypothesized that patients with FAI experience diagnostic challenges causing delayed treatment. We assessed the 2-year diagnostic journeys of patients prior to hip arthroscopy by analyzing recurring hip-related hospital visits, magnetic resonance imaging (MRI), the geographical distribution, and healthcare settings of these visits related to hip pain using data from a nationwide database. Medical records in the national e-health database were reviewed to identify patients who underwent hip arthroscopy between January 2017 and May 2023. Patients aged 18-65 years with a minimum of 2 years of prior medical records were included. The number of clinic visits and MRI scans in the 2 years prior to hip arthroscopic FAI surgery were analyzed with distributions of age and sex. 1754 patients who were confirmed to have complete procedure notes were included in the study. Only 30 of the 81 provinces of Türkiye had hip arthroscopy entries (37.0%). The majority of patients presented at university hospitals on their first visit (35.3%), and 1544 patients (88%) underwent MRI prior to surgery. The median number of clinic visits was 9 (SD: 7.7) and that of MRI scans was 2 (range: 1-7) per patient. Patients under 40 years had a higher mean of orthopedic surgery clinic visits (M: 8.8, SD: 5.1) than those over 40 years (M: 8.1, SD: 6.0) (p = 0.01). There was no significant difference between men and women in mean orthopedic clinic visits (8.5 vs. 8.4, respectively). The findings suggest that patients with FAI undergo a considerable number of physician visits (median of 9) and MRI scans (median of 2) in the 2 years preceding hip arthroscopy in Türkiye. These results may indicate diagnostic challenges, delays in determining the need for surgery, and potential reluctance to undergo hip arthroscopy. Addressing these issues would require implementing strategies to reduce the time from symptom onset to treatment initiation and alleviate the financial burden associated with delayed diagnosis.
诊断股骨髋臼撞击症(FAI)具有挑战性,髋关节镜手术的手术指征仍在不断发展。本研究分析了一大群FAI患者术前的两年情况。我们假设FAI患者在诊断方面存在挑战,导致治疗延迟。我们通过分析与髋关节疼痛相关的反复髋关节相关医院就诊、磁共振成像(MRI)、这些就诊的地理分布以及医疗环境,利用全国性数据库的数据,评估了患者在髋关节镜手术前的两年诊断历程。对国家电子健康数据库中的病历进行了审查,以确定2017年1月至2023年5月期间接受髋关节镜手术的患者。纳入年龄在18 - 65岁且至少有两年既往病历的患者。分析了髋关节镜下FAI手术前两年的门诊就诊次数和MRI扫描次数,并按年龄和性别分布进行分析。1754名确认有完整手术记录的患者被纳入研究。土耳其81个省份中只有30个有髋关节镜手术记录(37.0%)。大多数患者首次就诊是在大学医院(35.3%),1544名患者(88%)在手术前接受了MRI检查。每位患者的门诊就诊中位数为9次(标准差:7.7),MRI扫描中位数为2次(范围:1 - 7次)。40岁以下患者的骨科门诊就诊平均次数(M:8.8,标准差:5.1)高于40岁以上患者(M:8.1,标准差:6.0)(p = 0.01)。男性和女性的骨科门诊就诊平均次数无显著差异(分别为8.5次和8.4次)。研究结果表明,在土耳其,FAI患者在髋关节镜手术前的两年中要进行相当数量的医生就诊(中位数为9次)和MRI扫描(中位数为2次)。这些结果可能表明存在诊断挑战、确定手术需求的延迟以及对接受髋关节镜手术的潜在抵触情绪。解决这些问题需要实施策略,以减少从症状出现到开始治疗的时间,并减轻与延迟诊断相关的经济负担。
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