Two-year outcomes after arthroscopic surgery compared to physical therapy for femoracetabular impingement: A protocol for a randomized clinical trial

The main analysis of effectiveness is performed using a linear mixed effect model that flexibly corresponds to the data assumed to be randomly lost. Each result is measured at 4 time points (baseline, 6, 12 and 24 months). Subjects are analyzed in groups that were originally assigned to them. Sensitivity analysis is done to evaluate the effect of treatment crossover on the outcome. Descriptive statistics are computed to characterize and compare two treatment groups to evaluate baseline inhomogeneities. Distribution of measured variables is visually examined using a histogram of frequency and formal evaluation is performed using Kolmogorov-Smirnov statistic and Shapiro-Wilk statistics to verify the normal hypothesis. The Levene test is used to evaluate the homogeneity of the violation distribution hypothesis. If parameter assumptions are satisfied, the baseline comparability of the group is tested using a t-test that does not correspond to Chi-square statistics categorical variable, otherwise Mann-Whitney U is tested I will. All statistical tests are done at an alpha level of 0.05.

If one treatment is shown to be superior to the other treatment, the HOS-based minimum clinical significance difference (MCID) and GROC score + 3 points are used for supplemental analysis by the two groups. Since clinically meaningful benefits are not of concern, this allows for absolute risk reduction, relative risk reduction and calculation of the amount of treatment required (at 95% confidence intervals).

Medical use is extracted from the Department of Defense's Military Medical System Data Repository (MDR) database. This is the system most commonly used in research by TRICARE and includes direct and purchased care data. For each patient in the study, the number and type of medical treatment related to the FAI related diagnosis, and the associated expenses are drawn. This includes diagnostic imaging, drug treatment and professional referrals. The utilization of each category is compared between groups

Surgical and Physical Therapy for Symptomatic Meniscal Laceroid Osteoarthritis Patients: For patients with meniscal tear images this is a blind test of arthroscopic surgery or physical therapy. Most patients were excluded from the study (exclusion criteria: chronic fixed knee joint, grade 40 A, cartilage calcification, bilateral tears, previous knee surgery) and a high crossover rate (30%). The main result was the body function score at 6 months, there was no difference between the groups; again there was no difference in the pain score. The main clinical point of view is that immediate surgery does not produce obvious benefit and therefore maintains this treatment for patients estimated to have one third of PT patients who can not improve It is reasonable.

In 2013, the Finnish team presented the results of 2 years of patients who underwent arthroscopic surgery to repair meniscal tears in a double-blind randomized controlled trial compared to sham operated patients Did. "Subsequent results are not better than the results after placebo surgery," Salis said he had seen at least three knee surgeries and research on shoulder, hip, and back surgery. In either case, the patient's outcome after placebo surgery reflects the results of legal surgery. "These findings are difficult for all of our sports medicine," he said.