FIRST

Why was this trial needed?

Femoroacetabular impingement (FAI) is a condition believed to cause hip pain in young adults due to an anatomical mismatch between the femoral head and the acetabulum, resulting in joint damage over time. Diagnosis and surgical treatment have become increasingly common, with hip arthroscopy rates rising rapidly. Despite widespread adoption, high-quality evidence supporting the effectiveness of arthroscopic osteochondroplasty has been limited, largely based on uncontrolled observational studies.

What is the primary objective of the FIRST trial?

FIRST was an international, multicenter randomized controlled trial led by researchers at McMaster University, Canada. The aim was to determine whether arthroscopic osteochondroplasty improves pain and function compared to arthroscopic lavage alone in adults diagnosed with FAI.

Where are we now?

We contributed to this project, particularly through Finnish participation coordinated by Matti Seppänen (Turku University Hospital). The trial protocol was published in BMC Musculoskeletal Disorders, and the primary results were reported in The American Journal of Sports Medicine:

• 2-year results

Several secondary analyses and subgroup studies have also been published. This collaboration has provided valuable data to inform the management of FAI, though discussions about interpretation and reporting have highlighted important challenges in surgical trials.

Project team

Olufemi R. Ayeni, McMaster University, Hamilton, Canada (Principal investigator)
Mohit Bhandari, McMaster University, Hamilton, Canada (Principal investigator)

FICEBO:
Teppo Järvinen – Matti Seppänen – Raine Sihvonen – Pirjo Toivonen, Project coordinator – Mari Routapohja – Mika Junnila

Contributors

Steering committee

Olufemi R. Ayeni – Mohit Bhandari – Teppo Järvinen – Matti Seppänen – Asheesh Bedi – Volker Musahl – Douglas Naudie – Gerard Slobogean – Lehana Thabane

‍

‍