The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on arthroscopic femoro-acetabular surgery for hip impingement syndrome.
This document replaces previous guidance on arthroscopic femoro–acetabular surgery for hip impingement syndrome (NICE interventional procedures guidance 213, March 2007).
Hip impingement syndrome is caused by unwanted contact between abnormally shaped parts of the head of the thigh bone and the hip socket. This results in limited hip movement and pain. The aim of femoro–acetabular surgery is to improve range of movement and reduce pain. It is believed that it may also help prevent hip arthritis in later life. With the patient under general anaesthesia, a special camera (called an arthroscope) is inserted into the hip joint through a small incision. Using instruments inserted through one or two additional incisions, the surgeon removes some of the cartilage or bone, with the aim of reshaping the joint surface. Unlike open surgery, in arthroscopic surgery the hip joint does not need to be dislocated, and recovery is thought to be quicker.
This procedure cannot be expressed in the OPCS-4 classification by a single code. Procedures could vary for each patient depending on the nature of the condition, and these would be coded on a case by case basis based on the specific procedures carried out.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.