'Do Patient Characteristics Associate With Poor Outcome With Femoral Acetabular Impingement Syndrome (FAIS) Following Physiotherapy-led Rehabilitation'

NCT07460401 | Not Yet Recruiting

• 2 other identifiers: 25/YH/0258358680
• Study Type: observational
• Target: 175
• Locations: 1 country
• Sites: 1

Brief Summary

Background: The hip joint is a ball and socket joint where the ball inserts into the socket. The ball shape is round but sometimes the ball has a bony bump on it. When the ball moves in the socket, the bump can hit the edge of the socket causing pain in movements like squatting or kicking a ball. Repeated hitting of the bump in the socket can cause hip pain, damage, and arthritis. This is called hip impingement and is found in 10-15% of young adults. Does Physiotherapy treatment work? Exercises from a physiotherapist make the muscles stronger around the hip joint which alters the way the ball moves. This stops the bump hitting the socket and this can help reduce the pain. However, an experiment found only 32% of people doing exercises got better. So, why after strengthening the muscles are some people still in pain? Is there another source of pain? Other causes of pain? The investigators know things like people's emotions such as 'feeling down' can affect pain. An experiment the investigators did, found neuropathic pain in people with hip impingement. This pain is caused by a disease of the nerves that provide information about your body. This can be a cause of pain even if your muscles are strong. In both situations, strengthening your muscles may not be the best choice. The investigators need to know more about types of pain in people with hip impingement to give better treatment. Aim To look at causes of hip impingement in people before they have physiotherapy treatment, to see if the investigators can find a reason why some people don't get better after strengthening their muscles. Project design The investigators will review the research to see if people with hip impingement may feel for example, sad, anxious or scared of moving their hip, which could be a reason why some people don't get better after doing their strengthening exercises. The investigators will invite 175 adults with hip impingement who have been referred for physiotherapy-led treatment to join this study. The participants will have 2 research appointments, 30-60 minutes each. The first one before the start of their physiotherapy treatment, the second one will be 4 months after starting their physiotherapy treatment. At both appointments the participants will complete special questionnaires designed to explore emotions and causes of pain. The investigators will compare the results of the questionnaires which will give more information about the causes of pain and how people view their pain. This will give the investigators a better understanding why strengthening exercises may not be the best treatment. Patient and public involvement (PPI) The investigators presented this project to 23 members of the public (who help researchers with their projects) at our monthly meeting. They thought this project was a good idea, especially talking about things like anxiety and depression. This will form part of the questionnaires. Patients told the investigators about their thoughts of having pain following treatment for hip pain. They felt further knowledge into why they had pain and help with mental and emotional support was important to them. They told the investigators about their concerns over the lack of information about what treatment can and cannot achieve. They were reluctant to suggest treatment. Three patients would like to help the investigators further design the study so that the information available to the public is clear and concise.

Conditions

Femoral Acetabular Impingement

Keywords

Hip impingement; Patient characteristics; Outcomes; Physiotherapy-led rehabilitation

Outcome Measures

Primary Outcomes (2)

• International Hip Outcome Score33 (iHOT33)

  this is a validated hip quality of life questionnaire for FAIS. The iHOT33 provides a 100-point score with 100 representing no pain and perfect function, and a lower scores indicating pain and poorer function. The iHOT33 has a minimal clinically important difference of 6.1 points

  1 week maximum from enrolment to recording baseline iHOT33. This should ideally be done on the day of enrolment.

• Average pain over 4 weeks

  Is a unidimensional measure of pain intensity and is a widely used outcome for pain in the adult population for conditions such as chronic pain, rheumatic diseases etc. It is measured on a 100 mm line with an anchor point at 0 mm for 'no pain' and 100 mm representing severe pain. The participant is asked to mark on the 100 mm line their current pain intensity. The pain score is calculated using a ruler to measure along the 100 mm line where the mark on the scale lies.

  On the day of enrolment or within one week

Secondary Outcomes (8)

• Neuropathic Pain Symptom Inventory (NPSI)

  On the day of enrolment or within one week

• • Douleur Neuropathique 4 -Interview

  On the day of enrolment or within one week

• Hospital Anxiety and Depression scale (HADS):

  on the day of enrolment or within one week

• Widespread pain index (WPI)

  On the day of recruitment or within one week

• Pain Catastrophising Scale (PCS)

  On the day or enrolment or within one week.

Study Arms (1)

Patients diagnosed with femoral acetabular impingement syndrome

Adult male or female participants with a formal diagnosis of FAIS who meet the inclusion criteria: * Participants aged between 18 and 55 years * Diagnosis of symptomatic FAIS following a formal clinical assessment * Appropriate imaging: MRI/Arthrogram, and /or Xray and/or CT (secondary care pathway for diagnosis but this is optional). * Awaiting PLR * No previous surgery to the index hip * Have capacity to give informed consent * English as a spoken language Exclusion Criteria The participant may not enter the study if ANY of the following apply: * Presence of hip dysplasia, femoral stress fracture, synovitis or other inflammatory arthropathy (psoriatic arthropathy) * Kellgren-Lawrence grading of Osteoarthritis ≥2 (to exclude moderate OA) * Avascular necrosis of the femoral head * Previous surgery to index hip * Previous physiotherapy treatment to the index hip in the past 6 months * Current pregnancy * Perthes disease * Involved in a current research study involving the hip

Other: No intervention assigned. This is an observational study

Interventions

No intervention assigned. This is an observational study OTHER

No intervention assigned

Patients diagnosed with femoral acetabular impingement syndrome

Eligibility Criteria

• Age: 18 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Adult male or female participants with a formal diagnosis of FAIS who meet the inclusion criteria

You may qualify if:

• Participants aged between 18 and 55 years
• Diagnosis of symptomatic FAIS following a formal clinical assessment - Appropriate imaging: MRI/Arthrogram, and /or Xray and/or CT (secondary care pathway for diagnosis but this is optional).
• Awaiting PLR
• No previous surgery to the index hip
• Have capacity to give informed consent
• English as a spoken language

You may not qualify if:

• Presence of hip dysplasia, femoral stress fracture, synovitis or other inflammatory arthropathy (psoriatic arthropathy)
• Kellgren-Lawrence grading of Osteoarthritis ≥2 (to exclude moderate OA which could be a confounding influence on pain)
• Avascular necrosis of the femoral head
• Previous surgery to index hip
• Previous physiotherapy treatment to the index hip in the past 6 months
• Current pregnancy
• Perthes disease
• Involved in a current research study involving the hip

Sponsors & Collaborators

• University of Oxford: lead
• Oxford University Hospitals NHS Trust: collaborator

Study Sites (1)

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences

Oxford, Oxfordshire, OX3 7LD, United Kingdom

Location

Related Publications (7)

• Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002 Feb;52(2):69-77. doi: 10.1016/s0022-3999(01)00296-3.

  PMID: 11832252 BACKGROUND

• Mohtadi NG, Griffin DR, Pedersen ME, Chan D, Safran MR, Parsons N, Sekiya JK, Kelly BT, Werle JR, Leunig M, McCarthy JC, Martin HD, Byrd JW, Philippon MJ, Martin RL, Guanche CA, Clohisy JC, Sampson TG, Kocher MS, Larson CM; Multicenter Arthroscopy of the Hip Outcomes Research Network. The Development and validation of a self-administered quality-of-life outcome measure for young, active patients with symptomatic hip disease: the International Hip Outcome Tool (iHOT-33). Arthroscopy. 2012 May;28(5):595-605; quiz 606-10.e1. doi: 10.1016/j.arthro.2012.03.013.

  PMID: 22542433 BACKGROUND

• Shedden-Mora MC, Alberts J, Petrie KJ, Laferton JAC, von Blanckenburg P, Kohlmann S, Nestoriuc Y, Lowe B. The Treatment Expectation Questionnaire (TEX-Q): Validation of a generic multidimensional scale measuring patients' treatment expectations. PLoS One. 2023 Jan 23;18(1):e0280472. doi: 10.1371/journal.pone.0280472. eCollection 2023.

  PMID: 36689398 BACKGROUND

• Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000 Jun;31(2):73-86. doi: 10.1016/s0005-7916(00)00012-4.

  PMID: 11132119 BACKGROUND

• Hauser W, Jung E, Erbsloh-Moller B, Gesmann M, Kuhn-Becker H, Petermann F, Langhorst J, Weiss T, Winkelmann A, Wolfe F. Validation of the Fibromyalgia Survey Questionnaire within a cross-sectional survey. PLoS One. 2012;7(5):e37504. doi: 10.1371/journal.pone.0037504. Epub 2012 May 25.

  PMID: 22662163 BACKGROUND

• Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain. 2005 Sep;117(1-2):137-44. doi: 10.1016/j.pain.2005.05.029.

  PMID: 16055269 BACKGROUND

• Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, Rostaing S, Lanteri-Minet M, Collin E, Grisart J, Boureau F. Development and validation of the Neuropathic Pain Symptom Inventory. Pain. 2004 Apr;108(3):248-257. doi: 10.1016/j.pain.2003.12.024.

  PMID: 15030944 BACKGROUND

MeSH Terms

Conditions

Femoracetabular Impingement

Condition Hierarchy (Ancestors)

Joint Diseases; Musculoskeletal Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Steve Gwilym, DPhil

  Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences

  PRINCIPAL INVESTIGATOR

• Sion Glyn-jones, DPhil

  Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences

  PRINCIPAL INVESTIGATOR

• Victoria Harris, PhD

  Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences

  PRINCIPAL INVESTIGATOR

• Katja Weich, DPhil

  Nuffield Department of Clinical Sciences

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Simon J Wood, MSc

CONTACT

+441865741155; simon.wood@ndorms.ox.ac.uk

Karen L Barker, Professor

CONTACT

01865 738074; karen.barker@ndorms.ox.ac.uk

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 3, 2026
• First Posted: March 10, 2026
• Study Start: April 6, 2026
• Primary Completion (Estimated): October 31, 2027
• Study Completion (Estimated): January 31, 2028
• Last Updated: April 2, 2026

Record last verified: 2026-03

Locations

GB (1)