UK FASHIoN is a 348-patient multicentre RCT comparing hip arthroscopy to personalised hip therapy (structured physiotherapy) for femoroacetabular impingement syndrome. It is the first randomised trial to test whether surgery outperforms best conservative care for this condition. The primary outcome was hip-related quality of life measured by iHOT-33 at 12 months.
Hip arthroscopy had expanded rapidly — over 1,900 procedures performed in the UK in 2013 alone. Without a single RCT demonstrating superiority over conservative care. A 2014 Cochrane review confirmed the evidence gap.
UK FASHIoN fills that gap. When counseling a young patient with symptomatic cam-type FAI who has completed a structured physiotherapy programme without adequate relief, this trial supports offering arthroscopy.
Do not oversell the result. The absolute benefit is modest (6.8 points on a 100-point scale), cost-effectiveness at 12 months is negative, and the surgical benefit was non-significant in pincer-only and mixed-type FAI. Share these numbers with patients when discussing treatment options.
One nuance worth internalising: scores were identical between groups at 6 months. The benefit only emerged by 12 months, and patients had a median of only 122 days post-op before the primary endpoint. Suggesting the true long-term surgical advantage may be larger than reported here, pending the planned 2-, 3-, 5-, and 10-year follow-up.
UK FASHIoN is a 348-patient multicentre RCT comparing hip arthroscopy to personalised hip therapy (structured physiotherapy) for femoroacetabular impingement syndrome. It is the first randomised trial to test whether surgery outperforms best conservative care for this condition. The primary outcome was hip-related quality of life measured by iHOT-33 at 12 months.
Hip arthroscopy had expanded rapidly — over 1,900 procedures performed in the UK in 2013 alone. Without a single RCT demonstrating superiority over conservative care. A 2014 Cochrane review confirmed the evidence gap.
UK FASHIoN fills that gap. When counseling a young patient with symptomatic cam-type FAI who has completed a structured physiotherapy programme without adequate relief, this trial supports offering arthroscopy.
Do not oversell the result. The absolute benefit is modest (6.8 points on a 100-point scale), cost-effectiveness at 12 months is negative, and the surgical benefit was non-significant in pincer-only and mixed-type FAI. Share these numbers with patients when discussing treatment options.
One nuance worth internalising: scores were identical between groups at 6 months. The benefit only emerged by 12 months, and patients had a median of only 122 days post-op before the primary endpoint. Suggesting the true long-term surgical advantage may be larger than reported here, pending the planned 2-, 3-, 5-, and 10-year follow-up.