Surgery is no more effective than conservative treatment for Femoroacetabular impingement syndrome: Systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 026921552096669 ◽  
Author(s):  
Robson Massi Bastos ◽  
Jorge Geraldo de Carvalho Júnior ◽  
Suellen Aline Martinez da Silva ◽  
Shirley Ferreira Campos ◽  
Matheus Vieira Rosa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Femoroacetabular Impingement ◽  
Methodological Quality ◽  
Impingement Syndrome ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Quality Evidence

Objective: To summarize the effects of surgical treatment compared to conservative treatment in femoroacetabular impingement syndrome in the short, medium, and long term. Study Design: Systematic review Methods: The following databases were searched on 14/09/2020: MEDLINE, EMBASE, CENTRAL, Web of Science, and PEDro. There were no date or language limits. The methodological quality assessment was performed using the PEDro scale and the quality of the evidence followed the GRADE recommendation. The outcomes pain, disability, and adverse effects were extracted. Results: Of 6264 initial studies, three met the full-text inclusion criteria. All studies were of good methodological quality. Follow up ranged from six months to two years, with 650 participants in total. The meta-analyses found no difference in disability between surgical versus conservative treatment, with a mean difference (MD) between groups of 3.91 points (95% CI –2.19 to 10.01) at six months, MD of 5.53 points (95% CI –3.11 to 14.16) at 12 months and 3.8 points (95% CI –6.0 to 13.6) at 24 months. The quality of the evidence (GRADE) varied from moderate to low across all comparisons. Conclusion: There is moderate-quality evidence that surgical treatment is not superior to conservative treatment for femoroacetabular impingement syndrome in the short term, and there is low-quality evidence that it is not superior in the medium term. Level of evidence: Therapy, level 1a. Registration number: PROSPERO CRD42019134118

scholarly journals Evaluation of outcome reporting trends for femoroacetabular impingement syndrome- a systematic review

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Ida Lindman ◽  
Sarantos Nikou ◽  
Axel Öhlin ◽  
Eric Hamrin Senorski ◽  
Olufemi Ayeni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Femoroacetabular Impingement ◽  
Arthroscopic Surgery ◽  
Impingement Syndrome ◽  
Harris Hip Score ◽  
Level Of Evidence ◽  
Continuous Increase ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported

Abstract Purpose The aim of this systematic review was to evaluate the trends in the literature regarding surgical treatment for femoroacetabular impingement syndrome (FAIS) and to present which patient-reported outcome-measures (PROMs) and surgical approaches are included. Methods This systematic review was conducted with the PRISMA guidelines. The literature search was performed on PubMed and Embase, covering studies from 1999 to 2020. Inclusion criteria were clinical studies with surgical treatment for FAIS, the use of PROMs as evaluation tool and studies in English. Exclusion criteria were studies with patients < 18 years, cohorts with < 8 patients, studies with primarily purpose to evaluate other diagnoses than FAIS and studies with radiographs as only outcomes without using PROMs. Data extracted were author, year, surgical intervention, type of study, level of evidence, demographics of included patients, and PROMs. Results The initial search yielded 2,559 studies, of which 196 were included. There was an increase of 2,043% in the number of studies from the first to the last five years (2004–2008)—(2016–2020). There were 135 (69%) retrospective, 55 (28%) prospective and 6 (3%) Randomized Controlled Trials. Level of evidence ranged from I-IV where Level III was most common (44%). More than half of the studies (58%) originated from USA. Arthroscopic surgery was the most common surgical treatment (85%). Mean follow-up was 27.0 months (± 17 SD), (range 1.5–120 months). Between 1–10 PROMs were included, and the modified Harris Hip Score (mHHS) was most commonly used (61%). Conclusion There has been a continuous increase in the number of published studies regarding FAIS with the majority evaluating arthroscopic surgery. The mHHS remains being the most commonly used PROM.

Criteria for Return to Play After Hip Arthroscopy in the Treatment of Femoroacetabular Impingement: A Systematic Review

2021 ◽  
pp. 036354652110389
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Matthew G. Davey ◽  
Jordan W. Fried ◽  
Andrew J. Hughes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Operative Management ◽  
Return To Play ◽  
Return To Sports ◽  
Level Of Evidence ◽  
The Mean

Background: Femoroacetabular impingement (FAI) is a common pathology in athletes that often requires operative management in the form of hip arthroscopy. Purpose: To systematically review the rates and level of return to play (RTP) and the criteria used for RTP after hip arthroscopy for FAI in athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature, based on the PRISMA guidelines, was performed using PubMed, Embase, and Scopus databases. Studies reporting outcomes after the use of hip arthroscopy for FAI were included. Outcomes analyzed were RTP rate, RTP level, and criteria used for RTP. Statistical analysis was performed using SPSS software. Results: Our review found 130 studies, which included 14,069 patients (14,517 hips) and had a mean methodological quality of evidence (MQOE) of 40.4 (range, 5-67). The majority of patients were female (53.7%), the mean patient age was 30.4 years (range, 15-47 years), and the mean follow-up was 29.7 months (range, 6-75 months). A total of 81 studies reported RTP rates, with an overall RTP rate of 85.4% over a mean period of 6.6 months. Additionally, 49 studies reported the rate of RTP at preinjury level as 72.6%. Specific RTP criteria were reported in 97 studies (77.2%), with time being the most commonly reported item, which was reported in 80 studies (69.2%). A total of 45 studies (57.9%) advised RTP at 3 to 6 months after hip arthroscopy. Conclusion: The overall rate of reported RTP was high after hip arthroscopy for FAI. However, more than one-fourth of athletes who returned to sports did not return at their preinjury level. Development of validated rehabilitation criteria for safe return to sports after hip arthroscopy for FAI could potentially improve clinical outcomes while also increasing rates of RTP at preinjury levels.

Analysis of Surgical Treatment Outcomes in Femoroacetabular Impingement Syndrome

2012 ◽  
Vol 32 (5) ◽  
pp. 1201-1206 ◽  
Author(s):  
Murat BÜLBÜL ◽  
Metin UZUN ◽  
Semih AYANOĞLU ◽  
Yunus İMREN ◽  
Kahraman ÖZTÜRK ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Treatment Outcomes ◽  
Femoroacetabular Impingement ◽  
Impingement Syndrome ◽  
Femoroacetabular Impingement Syndrome

scholarly journals Quantification of Acetabular Coverage on 3-Dimensional Reconstructed Computed Tomography Scan Bone Models in Patients With Femoroacetabular Impingement Syndrome: A Descriptive Study

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110494
Author(s):  
Steven F. DeFroda ◽  
Thomas D. Alter ◽  
Floor Lambers ◽  
Philip Malloy ◽  
Ian M. Clapp ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Femoral Head ◽  
Femoroacetabular Impingement ◽  
Impingement Syndrome ◽  
Acetabular Coverage ◽  
Level Of Evidence ◽  
Average Percentage ◽  
3 Dimensional ◽  
Inferior Aspect ◽  
Femoroacetabular Impingement Syndrome

Background: Accurate assessment of osseous morphology is imperative in the evaluation of patients with femoroacetabular impingement syndrome (FAIS) and hip dysplasia. Through use of computed tomography (CT), 3-dimensional (3D) reconstructed hip models may provide a more precise measurement for overcoverage and undercoverage and aid in the interpretation of 2-dimensional radiographs obtained in the clinical setting. Purpose: To describe new measures of acetabular coverage based on 3D-reconstructed CT scan bone models. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Preoperative CT scans were acquired on the bilateral hips and pelvises of 30 patients before arthroscopic surgical intervention for FAIS. Custom software was used for semiautomated segmentation to generate 3D osseous models of the femur and acetabulum that were aligned to a standard coordinate system. This software calculated percentage of total acetabular coverage, which was defined as the surface area projected onto the superior aspect of the femoral head. The percentage of coverage was also quantified regionally in the anteromedial, anterolateral, posteromedial, and posterolateral quadrants of the femoral head. The acetabular clockface was established by defining 6 o’clock as the inferior aspect of the acetabular notch. Radial coverage was then calculated along the clockface from the 9-o’clock to 5-o’clock positions. Results: The study included 20 female and 10 male patients with a mean age of 33.6 ± 11.7 years and mean body mass index of 27.8 ± 6.3. The average percentage of total acetabular coverage for the sample was 57% ± 6%. Acetabular coverages by region were as follows: anteromedial, 78% ± 7%; anterolateral, 18% ± 7%, posterolateral, 33% ± 13%, and posteromedial, 99% ± 1%. The acetabular coverage ranged from 23% to 69% along the radial clockface from 9 to 5 o’clock. Conclusion: This study demonstrated new 3D measurements to characterize acetabular coverage in patients with FAIS and elucidated the distribution of acetabular coverage according to these measurements.

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