The effectiveness of surgical treatment of femoroacetabular impingement: a systematic review.

Am J Sports Med, Nov 2010
Ng VY, Arora N, Best TM, Pan X, Ellis TJ
Recent studies on the surgical treatment of femoroacetabular impingement (FAI) have introduced a great deal of data into the international literature. However, there is no clear consensus on the effectiveness of this treatment. The aim of this paper was to answer four questions on the basis of the international literature: (1) Does treatment for femoroacetabular impingement succeed in improving symptoms? (2) In which subgroup of patients should surgical treatment be avoided? (3) Is the technique of labral refixation superior to simple partial resection? (4) Does treatment for femoroacetabular impingement alter the natural course of osteoarthritis in young patients?
23 case series were examined, and a systematic review was carried out on them. Data were collected from all the papers in order to answer the above 4 questions. These studies covered 970 patient cases; one study was level II, two were level III and 20 were level IV. All the studies showed improvement in patients' symptoms. Approximately 30% of patients ultimately needed total hip arthroplasty. Patients found intraoperatively to have Outerbridge grade 3 or 4 chondral lesions, or in whom osteoarthritic changes greater than Tonnis grade 1 were observed, will have poorer results with surgical treatment for femoroacetabular impingement. Only 2 studies directly compared labral refixation with partial resection of the labrum.
The authors concluded that these results can be used to help predict the outcome of surgical treatment of femoroacetabular impingement in various patient populations and to assess the need for labral refixation.