PERSPECTIVES

Drs. Ayeni and Bhandari talked about the trending topics in sports medicine, recent publications to read and the research questions yet to be answered. Our discussion uncovered 3 core themes. These themes and their supporting insights are highlighted below.

1. Trending topics: role of hip preservation, remote education using virtual approaches, and biologics in surgery.

Dr. Ayeni regards the concept of joint preservation as a trending topic in sports medicine. Total hip replacement has been widely used since its inception in the middle of last century. Currently, surgeons are using more clinical data to investigate the role of hip preservation and the consequential patient outcomes. There has been an increasing interest in research on hip preservation with doubling academic productivity every three to five years. Dr. Ayeni and colleagues are working together to produce high-quality evidence on this topic.

In Dr. Ayeni’s opinion, the COVID-19 pandemic has driven up the adoption of virtual training and virtual meetings. Remote education and its applications will continue to be a trending topic in sports medicine. Research on the potential beneficial role of biologic technology in surgery such as cartilage restoration and soft tissue augmentation is also a trending topic.

2. Arthroscopic osteochondroplasty is beneficial for young adults with femoroacetabular impingement.

Dr. Ayeni shared his research that could be of interest to orthopedic surgeons. Femoroacetabular Impingement Randomized Controlled Trial (FIRST) found that for young adults diagnosed with nonarthritic femoroacetabular impingement (FAI), correcting the impingement and correcting any soft tissue damage improved patients’ hip function and quality of life at 1 year. Osteochondroplasty with or without labral repair was associated with a lower rate of reoperation at 2 years, compared with arthroscopic lavage.

Dr. Ayeni believes that the FIRST study helps clinicians understand the natural history of a patients' condition after FAI correction surgery, as well as the patients who did not receive a correcting FAI surgery. The study provides evidence in managing the hip condition of the young adults with FAI. It is the first trial in publication associated with this research topic.

Article recommended by Dr. Ayeni

ACE report: Similar 1 Year Clinical Outcomes & Lower Reoperation Rate with Osteochondroplasty vs Lavage in FAI

Femoroacetabular Impingement Randomized Controlled Trial (FIRST) Investigators, Ayeni OR, Karlsson J, Heels-Ansdell D, Thabane L, Musahl V, Simunovic N, Duong A, Bhandari M, Bedi A, Järvinen T, Naudie D, Seppänen M, Slobogean G, Skelly M, Shanmugaraj A, Crouch S, Sprague S, Buckingham L, Ramsay T, Lee J, Kousa P, Carsen S, Choudur H, Sim Y, Johnston K, Sprague S, Wong I, Murphy R, Sparavalo S, Whelan D, Khan R, Wood GCA, Howells F, Grant H, Naudie D, Zomar B, Pollock M, Willits K, Firth A, Wanlin S, Remtulla A, Kaniki N, Belzile EL, Turmel S, Jørgensen U, Gam-Pedersen A, Hatanpää T, Sihvonen R, Raivio M, Toivonen P, Routapohja MP. Osteochondroplasty and Labral Repair for the Treatment of Young Adults With Femoroacetabular Impingement: A Randomized Controlled Trial. Am J Sports Med. 2021 Jan;49(1):25-34. doi: 10.1177/0363546520952804. Epub 2020 Sep 24. PMID: 32970955.

3. Global collaboration is important in large trials.

Patients in the FIRST trial were recruited from multiple countries and study sites including Denmark, Finland and Canada. Dr. Ayeni shared that there were co-investigators and adjudicators from the United States and other European countries also involved in the trial, and it was important to have such global collaboration.

SENSE-MAKING

Dr. Ayeni shared updates on the trending topics in sports medicine across three main areas: the role of hip preservation and possibility of switching back to this approach from the prevalent total hip replacement, remote education using virtual approaches, and biologics in surgery. Dr. Ayeni recommended an important paper to read, the recently published FIRST trial that evaluated effects of osteochondroplasty among the young adults with FAI. Dr. Ayeni and the team are working on evaluation of a natural history of FAI development by tracking adolescent activity and role of a biological scaffold for cartilage fixation in FAI.