Arthroscopic versus open treatment for femoroacetabular impingement

Abstract

Background: Femoroacetabular impingement (FAI) is a common cause of hip pain and restricted range of motion in young adults and athletes. This study aims to compare clinical results and complications between patients treated for FAI who underwent either arthroscopic or open treatment. Methods: The 7 studies were acquired from PubMed, Medline, Embase, and Cochrane Library. The data were extracted analyzed by RevMan5.3. Mean differences (MDs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated. The Newcastle–Ottawa Scale were used to assess risk of bias. Results: Seven observational studies were assessed. The methodological quality of the trials indicated a low risk of bias. The pooled results of the modified Harris Hip Score (mHHS), the Non-Arthritic Hip Score (NAHS), the Visual Analogue Scale (VAS), and satisfaction rate showed that the differences were not statistically significant between arthroscopic treatment (AT) and open treatment (OT). The difference of postoperative alpha angle was statistically significant, and OT was more effective [MD = 3.08, 95% confidence interval (95% CI) = 1.45–4.70, P = .0002]. The difference of postoperative internal rotation angle was statistically significant, and OT had better internal rotation angle (MD = -3.21, 95% CI = -6.14 to -0.28, P = .03). However, the difference of complications was statistically significant and AT achieved better result than OT (OR = 0.41, 95% CI = 0.22–0.74, P =0.003). Conclusion: AT had comparable effect and lower complications than OT, but had less improvement in alpha angle and internal rotation angle.

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

“…The result is inconsistent with our results, but our study included more RCTs (six vs three) and we use more scale comparisons as clinical results. Another literature presented the same result as our result, though it only contained three studies and one outcome [ 30 ]. Based on the current lack of high-quality evidence, in contrast, our results are more convincing.…”

Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient

“…A relatively recent review of the treatment of symptomatic adolescent FAI compared open versus arthroscopic techniques. 14 There were significant improvements in patient pain, function, and satisfaction rates with the open cohort having a slightly lower revision rate. However, this comparison is likely confounded by differences in the populations undergoing these procedures.…”

“…While HA is increasingly being utilized, SD is now typically reserved for severely complex cases. A relatively recent review of the treatment of symptomatic adolescent FAI compared open versus arthroscopic techniques 14 . There were significant improvements in patient pain, function, and satisfaction rates with the open cohort having a slightly lower revision rate.…”

Harms Reporting Is Inadequate in Systematic Reviews Regarding Hip Arthroscopy

“… 29 (2016) Qiao et al. 30 (2020) Nerve damage Nerve paresis Wound infection Superficial infection Wound dehiscence Reoperation Hematoma Heterotopic ossification Deep venous thrombosis Heterotopic ossification Transient paresthesia of the pudendal nerve Persistent pain New-onset symptomatic internal snapping Reversible pudendal nerve paresis Perineal cutaneous necrosis Compartment syndrome Percentage of harms mentioned in study of Qiao et al. (2020): 50.0% (2 of 4) Percentage of harms mentioned in study of Zhang et al.…”