Hip arthroscopy is a successful treatment for femoroacetabular impingement in under-16 competitive football players: a prospective study with minimum 2-year follow-up

ChatGPT Can Offer At Least Satisfactory Responses to Common Patient Questions Regarding Hip Arthroscopy

PURPOSE

To assess the accuracy of answers provided by ChatGPT 4.0 (an advanced language model developed by OpenAI) regarding 25 common patient questions about hip arthroscopy.

METHODS

ChatGPT 4.0 was presented with 25 common patient questions regarding hip arthroscopy with no follow-up questions and repetition. Each response was evaluated by 2 board-certified orthopaedic sports medicine surgeons independently. Responses were rated, with scores of 1, 2, 3, and 4 corresponding to "excellent response not requiring clarification," "satisfactory requiring minimal clarification," "satisfactory requiring moderate clarification," and "unsatisfactory requiring substantial clarification," respectively.

RESULTS

Twenty responses were rated "excellent" and 2 responses were rated "satisfactory requiring minimal clarification" by both of reviewers. Responses to questions "What kind of anesthesia is used for hip arthroscopy?" and "What is the average age for hip arthroscopy?" were rated as "satisfactory requiring minimal clarification" by both reviewers. None of the responses were rated as "satisfactory requiring moderate clarification" or "unsatisfactory" by either of the reviewers.

CONCLUSIONS

ChatGPT 4.0 provides at least satisfactory responses to patient questions regarding hip arthroscopy. Under the supervision of an orthopaedic sports medicine surgeon, it could be used as a supplementary tool for patient education.

CLINICAL RELEVANCE

This study compared the answers of ChatGPT to patients' questions regarding hip arthroscopy with the current literature. As ChatGPT has gained popularity among patients, the study aimed to find if the responses that patients get from this chatbot are compatible with the up-to-date literature.

Arthroscopic Procedure for Femoroacetabular Impingement Syndrome in Adolescents: A Systematic Review and Meta-analysis

Femoroacetabular impingement (FAI) is caused by aberrant anatomy involving the proximal femur with or without the acetabulum resulting in mechanical impingement. FAI's effects can be devastating in the young. In recent studies, significant associations have been found between skeletal immaturity, FAI, and sports involvement. Hip arthroscopy for FAI has been demonstrated to produce good results. We opted to update the review and meta-analysis to further narrow the research gap in the literature by including recently published studies and a comprehensive review of the arthroscopic approach for FAI. Prior to January 1, 2024, PubMed, Embase, and Google Scholar databases were searched for the studies with data on surgical procedures and patient-related outcomes for arthroscopic FAI. RevMan 5.2 was utilized to calculate the pooled mean differences with a 95% confidence interval to compare reported postoperative and preoperative patients' outcomes. In total, 24 studies of adolescent subjects with a mean age of less than 20 years, including 1,619 patients and 1,767 hips, were included. Eleven studies included acetabuloplasty and femoroplasty as major treatments. When preoperative and postoperative outcomes were compared, statistically significant changes were seen in the mHHS (modified Harris hip score), HOS-ADL (Hip Outcome Score-Activities of Daily Living), HOS-SSS (Hip Outcome Score-Sports-Specific Subscale), i-HOT (International Hip Outcome Tool 12 questions), NAHS (Nonarthritic Hip Score), and the visual analog scale. Numbness, neuropraxia and infections were seen in only 12 patients. This meta-analysis demonstrated overall improvements in hip pain, quality of life, and hip function along with few complications.

Comparative outcomes of hip arthroscopy for femoroacetabular impingement in football and non-football athletes: a clinical analysis

INTRODUCTION

Femoroacetabular impingement (FAI) is a common cause of hip pain and dysfunction, particularly among athletes, including football players. The condition is characterized by abnormal contact between the femoral head-neck junction and the acetabulum, leading to cartilage damage and labral tears. Hip arthroscopy has emerged as a minimally invasive treatment option, offering faster recovery and improved outcomes compared to traditional surgery. This study aims to compare outcomes between football players and non-football athletes undergoing hip arthroscopy for FAI.

MATERIALS AND METHODS

This retrospective, single-center study analyzed a database of patients undergoing hip arthroscopy for FAI between 2007 and 2023. The study compared football players (n = 16) and non-football athletes (n = 16), matched for age, sex, and BMI. Pre-operative assessment included the Hip Outcome Score (HOS), Visual Analog Scale (VAS), and other functional questionnaires. Radiographic evaluations included the alpha and Wiberg angles, and intra-operative findings were recorded. The surgical approach involved femoral and acetabular osteoplasty, labral repair, or labrectomy, depending on injury morphology.

RESULTS

Both groups showed similar pre-operative pain levels (VAS) and functional scores. However, significant differences were observed in the Tegner and Hip Sports Activity Scores (HSAS), with football players showing higher activity levels pre-operatively. Both groups demonstrated significant improvements in alpha and Wiberg angles post-surgery (p < 0.001). The surgery duration was similar between groups, and no significant differences in post-operative outcomes were found between football and non-football players.

CONCLUSIONS

Hip arthroscopy is effective for both football and non-football players with FAI, with both groups experiencing significant improvements in hip joint function and pain relief. While pre-operative functional scores differed, particularly in activity levels, both groups benefited from similar post-operative outcomes, suggesting that the surgical approach is suitable for active individuals across different sports. Further research is needed to explore long-term outcomes and return-to-sport rates in these populations.

The evolving role and technique of hip arthroscopy in children and adolescents

Hip Arthroscopy in the pediatric and adolescent hip has evolved from its role as a diagnostic tool to a primary modality of management of variety of hip pathologies in children and adolescents. This article reviews current concepts and advances in hip arthroscopy in this population. We discuss the indications, techniques, outcomes, and complications of hip arthroscopy in children and adolescents. We explore the newer indications of hip arthroscopy in the treatment of SCFE (Slipped Capital Femoral Epiphysis) deformity correction, borderline hip dysplasia, septic arthritis, infantile developmental dysplasia, Perthes disease, and the existing and developing evidence. Finally, we address the challenges and future directions in research, education, and training, unique to the pediatric and adolescent population.

Key Concepts

(1)Hip arthroscopy has significant surgical applications in the pediatric and adolescent population, and can be used to help address several intra-articular as well as extra-articular pathologies.(2)The indications and potential for arthroscopic interventions and associated arthroscopic techniques is growing and developing rapidly, along with improving technology, techniques, and training.(3)FAI (Femoro Acetabular Impingement) and labral pathology are the most common indications for surgery in the adolescent, and clinical outcome studies show excellent results. However, nonoperative optimization should be strongly emphasized before surgical consideration.(4)Hip arthroscopy is minimally invasive and relatively low risk, though main risks and complications to be aware of is the potential need for revision or further surgery, transient neuropraxia of the pudendal nerve, surgical site infection, implant/tool-related breakage or failure, failed surgery, and venous thromboembolism.(5)Continued research and innovation in the field of pediatric hip arthroscopy are essential for further improving outcomes and expanding treatment options for young patients with hip disorders, and more pediatric-specific clinical research is needed.