Femoro Acetabular Impingement, Pain, Postoperative
Conditions
Keywords
Hip Arthroscopy, Warmed Fluids
Brief summary
The purpose of this study is to determine if pre-warming of arthroscopic fluid reduces immediate post-surgical pain in hip arthroscopy patients. The investigators hypothesize there will be a significant decrease in the Visual Analog Score (VAS) measured 30 minutes post-operatively in the warmed fluid group compared to the control group. Secondary outcome measures to be collected will include VAS scores 60 minutes after surgery and on post-operative day (POD) one. Additionally, the investigators will collect post-operative temperature measured 30 and 60 minutes post-operatively as well as morphine equivalent dosing in PACU and at the two-week follow up visit.
Detailed description
In the last two decades, hip arthroscopy for the treatment of femoral acetabular impingement has increased rapidly. Currently, over 30k hip scopes are performed annually in the United States (incidence 1.06 per 10K). Due to anatomical differences, hip arthroscopy procedures have the potential for significant fluid extravasation when compared to knee arthroscopy. A 2011 study on hip arthroscopy showed on average 9.68 liters of fluid were used for a standard hip procedure; of that 1.13 liters absorbed into the surrounding soft tissues. A recent systematic review and meta-analysis showed warming of arthroscopic fluids significantly decreased the risk of hypothermia during hip arthroscopy. Additionally, active warming has been shown to decrease the rate of surgical site infection during numerous procedures. In total knee arthroplasty patients, a forced air warming gown significantly reduced narcotic pain consumption compared to standard care. However, the benefits of active warming for decreasing post-operative pain has not been studied in hip arthroscopy patients. Specifically, the investigators were interested in the roll the pre-warming arthroscopic fluid plays in post-operative pain after hip arthroscopy. The purpose of this study is to see if pre-warming of arthroscopic fluid reduces immediate post-surgical pain and narcotic consumption in hip arthroscopy patients.
Interventions
PROCEDUREWarmed Arthroscopic Fluids
Warmed Arthroscopic Fluids
PROCEDURERoom Temperature Arthroscopic Fluids
Room Temperature Arthroscopic Fluids
Sponsors
University of Colorado, Denver
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
Sealed Opaque Envelope
Intervention model description
Prospective Randomized Controlled Trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* All patients aged 18-65 years with a confirmed diagnosis of Femoroacetabular impingement (FAI) * Required hip arthroscopy will be considered for the study * Pre-operative history and physical exam * Magnetic resonance imaging (MRI) before being indicated for arthroscopic surgery
Exclusion criteria
* Taking narcotic medications at baseline * Have a history of complex regional pain syndrome, * Have hip arthritis, * Have undergone previous hip arthroscopic surgery, or * Are deemed incapable by the Principal Investigator of completing the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Visual Analog Score | Pre-operatively, 30 and 60 minutes after completion of surgery, Post Op Days 1 and 14. | A Visual Analog Score (VAS) will be measured pre-operatively, 30 and 60 minutes after patient arrival in the post-anesthesia care unit (PACU). Additionally, VAS will be collected in the clinic on post-operative day (POD) 1 and POD 14. The visual analog scale measures subject reported pain on a scale of 0-100 with a score of 0 indicating no pain and 100 indicating the worst pain possible. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Temperature | 30-60 minutes after after completion of surgery | Subject core temperature will be collected 30 and 60 minutes after arrival in PACU. The method for collection will be done via current standard of care. |
| Morphine Equivalent Dosage (MED) | After completion of surgery and at the 2-week Post Operative Visit | Morphine equivalent dose (MED) will be calculated in PACU and at the subject's routine two-week post-operative appointment via medication reconciliation. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Hip Outcomes Score (HOS) | Pre-operatively | The HOS has been validated in patients with femoral acetabular impingement and has two subscales (Activities of Daily Living and Sports). The ADL subscale contained 19 items pertaining to basic daily activities, and the sports subscale contained 9 items pertaining to higher-level activities. The ADL and sports subscales are scored separately. The response to each item on the ADL subscale is scored from 4 to 0, with 4 indicating no difficulty and 0 indicating unable to do. The scores for each of the items are added together to obtain a total. The total number of items with a response is multiplied by 4 to obtain the highest potential score. The item score total is divided by the highest potential score. This value is then multiplied by 100 to obtain a percentage. The sports subscale is scored in a similar manner, with the highest potential score being 36. A higher score represents a higher level of physical function. |
| Veterans Rand 12 (VR-12) | Pre-Operatively | The Veterans RAND 12 Item Health Survey (VR-12) is a brief, generic, multi-use, self-administered health survey comprised of 12 items. The instrument is primarily used to measure health related quality of life and to estimate disease. The 12 items in the questionnaire correspond to eight principal physical and mental health domains including general health perceptions; physical functioning; role limitations due to physical and emotional problems; bodily pain; energy-fatigue, social functioning and mental health. The 12 items are summarized into two scores, a Physical Component Score (PCS) and a Mental Component Score (MCS). PCS and MCS summary scores are standardized using a t-score transformation and normed to a U.S. population of a score of 50 and a standard deviation of 10. The subscales are not combined or averaged for a total score. A Higher score represents a higher function. |
Countries
United States
Outcome results
None listed