Standardizing the Diagnostic Evaluation of Nonarthritic Hip Pain Through the Delphi Method

• Published in: Orthopaedic journal of sports medicine 2021-04, Vol.9 (4), p.2325967121991213-2325967121991213
• Main Authors: McClincy, Michael P., Wylie, James D., Williams, David N., Novais, Eduardo N.
• Format: Article
• Language: English
• Subjects: Delphi method; Medical diagnosis; Orthopedics; Pain; Sports medicine
• ISSN: 2325-9671; 2325-9671
• DOI: 10.1177/2325967121991213

Background: Femoroacetabular impingement and acetabular dysplasia have gained increased attention as nonarthritic sources of pain and dysfunction in young, active patients. To date, no standardized approach to the diagnostic evaluation of nonarthritic hip pain has been identified, as previous work has focused on the diagnostic evaluation and management of patients with femoroacetabular impingement undergoing hip arthroscopy. Purpose: To explore the standard diagnostic evaluation practice of experts in the field of hip preservation surgery and combine their expertise through the Delphi method to form a standardized approach to the diagnostic evaluation of patients with nonarthritic hip pain. Study Design: Consensus statement. Methods: An expert panel made up of 18 orthopaedic surgeons with extensive experience in the treatment of nonarthritic hip disorders participated in this Delphi study. The Delphi panelists were presented with 4 clinical vignettes representing a spectrum of patients with nonarthritic hip pain. Three iterative survey rounds were presented to the panelists based on these clinical vignettes, and a 3-step classic Delphi method was used to establish consensus techniques in the diagnostic evaluation of nonarthritic hip pain. Results: Total (100%) participation was gained, with all 18 experts completing all 3 Delphi survey rounds. Consensus (≥75% support) was achieved for some, if not all, vignettes for each of the following diagnostic domains: historical features, physical examination, radiographic sequences, radiographic interpretation, cross-sectional imaging, and ancillary diagnostics. Conclusion: In this Delphi study, we identified standardized diagnostic treatment approaches as derived from expert opinion for patients with nonarthritic hip pathomorphologies.