ACOEM publishes new medical treatment guidelines for hip and groin disorders

American College of Occupational and Environmental MedicineMay 26 2010

The American College of Occupational and Environmental Medicine (ACOEM) today published new medical treatment guidelines for providing care to workers with injuries and disorders of the hip and groin. The new guidelines, which represent the latest chapter in ACOEM's comprehensive publication Occupational Medicine Practice Guidelines, are available on line now via ACOEM's APG-I web application; a print version will be available in the fall of 2010, when the Third Edition hard-copy of Occupational Medicine Practice Guidelines is published.

More than 200 recommendations are featured in the new set of guidelines, focusing on diagnostic and other testing and treatments for hip and groin disorders. Conditions covered include acute, subacute, and chronic hip pain; hip osteoarthrosis; gluteus medius tendinosis and tears; trochanteric bursitis and greater trochanteric pain syndrome; femoroacetabular impingement, "hip impingement" and labral tears; osteonecrosis; hamstring and hip flexor strains; groin strains and adductor-related groin pain; lower abdominal strains; meralgia paresthetica; epididymo-orchitis; and hip fractures.

The new guidelines were developed by a multi-disciplinary panel that included specialists in occupational medicine, orthopedic surgery, and physical therapy. The guidelines follow ACOEM's enhanced methodology, highlighted by original systematic research and evidence-weighted recommendations.

"These new guidelines provide the most up-to-date, evidence-based approaches to care for occupational injuries available today, and will serve as a great help to occupational medicine community and all musculoskeletal injury providers," said Kurt Hegmann, MD, MPH, FACOEM, Editor in Chief of the Practice Guidelines.

An extensive volume of literature was used to develop the evidence-based recommendations in the new chapter. More than 1,500 references are featured, including 625 high- and moderate-quality randomized controlled trials or crossover trials.

Other highlights of the new chapter include:
• Discussion on the prevention of venous thromboembolic disease.
• Recommendations on hip arthroplasty and surgical recommendations for hip fracture.
• Recommendations for pre and post-operative rehabilitation, including hip arthroplasty and hip fractures.
• An appendix which covers anesthetic issues for hip surgery patients.
• An overview of each treatment option, indicating the existence or lack of evidence, and whether the option is costly, invasive, and has high/low risks or side effects.
• Algorithms for the different hip and groin disorders which offer quick and accurate guidance for cases with different progressions, circumstances, or outcomes.

ACOEM has announced that updates to ankle/foot, neck, knee and shoulder guidelines will follow electronic publication of the hip and groin chapter and will part of the Third Edition release later this year.