2023 ISAKOS Biennial Congress ePoster
The Radiographic Fear Index Is a Useful Diagnostic Tool In Patients Undergoing Hip Preservation Surgery: A Systematic Review
Dan Cohen, MD, Hamilton CANADA
Muyiwa Ifabiyi, MSc, London, ON CANADA
Graeme Matthewson, MD, Sherman Oaks, California CANADA
Nicole Simunovic, MSc, Hamilton, ON CANADA
Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, Hamilton, ON CANADA
McMaster University, Hamilton, Ontario, CANADA
FDA Status Not Applicable
Summary
This review supports the consistent use of the FEAR index as a useful diagnostic tool in hip preservation surgery particularly in patients with borderline dysplastic hips and may help dictate the optimal treatment strategy in select patients.
ePosters will be available shortly before Congress
Abstract
Purpose
The purpose of this review is to assess the utility of the FEAR index as a diagnostic tool in hip preservation surgery. The information in this review will provide surgeons with the most up-to-date evidence regarding the utility of the FEAR index allowing them to decide whether to incorporate this parameter into their clinical practice.
Methods
Three online databases (MEDLINE, Embase, and PubMed) were searched from database inception until May 2022, for literature addressing the utility of the FEAR index in patients undergoing hip preservation surgery. Given the lack of consistent reporting of patient outcomes across studies, the results are presented in a descriptive summary fashion.
Results
Overall, there were a total of 11 studies comprising 1458 patients in 1512 hips that reported on the diagnostic utility of the FEAR index. The mean MINORS score for comparative studies was 17.6 (range: 16-22) while the MINORS score for the one non-comparative study was 12. The intra observer agreement for the FEAR index was reported by 6/11 studies and the ICC ranged between 0.778 and 0.99 across studies. The inter observer agreement was reported by 7/11 studies with excellent agreement seen in 5/11 studies and good agreement seen in 2/11 studies. Among the 5 studies that differentiated between hip instability and hip impingement based on preoperative clinical physical and radiographic examination, the mean FEAR index in 319 patients in the instability group was 5.23 degrees while the mean FEAR index in 239 patients in the impingement group was -4.7 degrees while the mean FEAR index in 105 patients in the control group was -11.8 degrees
Conclusion
Overall, this review supports the consistent use of the FEAR index as a useful diagnostic tool in hip preservation surgery particularly in patients with borderline dysplastic hips and may help dictate the optimal treatment strategy in select patients.