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The evolution of femoroacetabular impingement surgical management as a model for introducing new surgical techniques

Journal article
Authors Axel Öhlin
R. P. Coughlin
Mattias Ahldén
Kristian Samuelsson
Henrik Malchau
M. R. Safran
O. R. Ayeni
Mikael Sansone
Published in Knee Surgery, Sports Traumatology, Arthroscopy
ISSN 0942-2056
Publication year 2019
Published at Institute of Clinical Sciences, Department of Orthopaedics
Language en
Keywords Evidence-based medicine, FAI, Hip arthroscopy
Subject categories Orthopedics


Introducing new surgical techniques and concepts can be difficult. There are many hurdles to overcome initially, such as the learning curve, equipment and technique development, before a standard of care can be established. In the past, new surgical techniques have been developed, and even widely accepted, before any scientific evaluation has been made. At that stage, it may be too late properly to evaluate the effectiveness of treatments, as the objectiveness and/or randomisation process may be obstructed. Since the introduction of evidence-based medicine (EBM), there have been high standards of scientific rigour to prove the efficacy of treatments. Based on the nature of evidence-based acceptance, innovations cannot be subjected to this final process before their evolution process is complete and, as a result, there is a need for the staged scientific development of new surgical techniques that should be adopted. This paper presents a model for this kind of stepwise introduction based on the actual evolution of FAI syndrome surgery. By following a scientific algorithmic methodology, new surgical techniques and concepts can be introduced in a stepwise manner to ensure the evidence-based progression of knowledge. © 2019, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

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