Conservative therapy versus arthroscopic surgery of femoroacetabular impingement syndrome (FAI): a systematic review and meta-analysis

J Orthop Surg Res. 2022 Jun 3;17(1):296. doi: 10.1186/s13018-022-03187-1.

Abstract

Purpose: FAI (femoroacetabular impingement syndrome) is a common cause of hip pain, resulting in a decreased life quality. This study aims to compare the postoperative clinical outcome between arthroscopic surgery (AT) and conservative treatment (CT).

Method: The six studies were selected from PubMed, Embase and OVID database. The data were extracted and analyzed by RevMan5.3. Mean differences and 95% confidence intervals were calculated. RevMan5.3 was used to assess the risk of bias.

Result: Six observational studies were assessed. The methodological quality of the trials indicated five of six studies had a low risk of bias and one article had a high risk of bias. The differences were statistically significant between AT and CT for HOS (follow-up for 6 months), iHOT-33 (follow-up for 6 months) improvement, iHOT-33 (follow-up for 12 months) improvement, iHOT-33 (follow-up for 12 months), EQ-5D-5L index score (follow-up for 12 months) and AT showed higher benefits than CT. Meanwhile no statistically significant were found in iHOT-33 (follow-up for 6 months), EQ-5D-5L index score (follow-up for 6 months), EQ5D-VAS (follow-up for 6 months) and EQ5D-VAS (follow-up for 12 months).

Conclusion: AT and CT both can have clinical effects when facing FAI. In our meta-analysis, hip arthroscopy is statistically superior to conservative treatment in both long-term and short-term effects.

Keywords: Arthroscopy; Conservative treatment; Femoroacetabular impingement syndrome.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Activities of Daily Living
  • Arthroscopy / methods
  • Conservative Treatment
  • Femoracetabular Impingement* / diagnostic imaging
  • Femoracetabular Impingement* / surgery
  • Hip Joint / surgery
  • Humans
  • Postoperative Period
  • Quality of Life
  • Treatment Outcome