Does Femoroacetabular Impingement Contribute to the Development of Hip Osteoarthritis? A Systematic Review

Kowalczuk, Marcin; Yeung, Marco; Simunovic, Nicole; Ayeni, Olufemi R.

doi:10.1097/jsa.0000000000000091

Cited by 80 publications

(45 citation statements)

References 46 publications

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“…A list of articles consisting of recent systematic reviews and original seminal research relevant to these topics was prepared; panel members suggested additional articles where important research had been omitted. The revised selection of publications was provided to all panel members along with the following final questions: What is FAI syndrome?3 15–17How should FAI syndrome be diagnosed?8 11 18–21What is the appropriate treatment of FAI syndrome?9 22–28What is the prognosis of FAI syndrome?13 29How should someone with an asymptomatic hip with cam or pincer morphology be managed?30 31Which outcome measures should be used to assess treatment for FAI syndrome?32–34What future research needs to be conducted?…”

Section: Methodsmentioning

confidence: 99%

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

et al. 2016

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The 2016 Warwick Agreement on femoroacetabular impingement (FAI) syndrome was convened to build an international, multidisciplinary consensus on the diagnosis and management of patients with FAI syndrome. 22 panel members and 1 patient from 9 countries and 5 different specialties participated in a 1-day consensus meeting on 29 June 2016. Prior to the meeting, 6 questions were agreed on, and recent relevant systematic reviews and seminal literature were circulated. Panel members gave presentations on the topics of the agreed questions at Sports Hip 2016, an open meeting held in the UK on 27-29 June. Presentations were followed by open discussion. At the 1-day consensus meeting, panel members developed statements in response to each question through open discussion; members then scored their level of agreement with each response on a scale of 0-10. Substantial agreement (range 9.5-10) was reached for each of the 6 consensus questions, and the associated terminology was agreed on. The term 'femoroacetabular impingement syndrome' was introduced to reflect the central role of patients' symptoms in the disorder. To reach a diagnosis, patients should have appropriate symptoms, positive clinical signs and imaging findings. Suitable treatments are conservative care, rehabilitation, and arthroscopic or open surgery. Current understanding of prognosis and topics for future research were discussed. The 2016 Warwick Agreement on FAI syndrome is an international multidisciplinary agreement on the diagnosis, treatment principles and key terminology relating to FAI syndrome.

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Section: Methodsmentioning

confidence: 99%

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

et al. 2016

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“…Numerous studies have demonstrated an association between the presence of FAI morphology and cartilage damage [38, 43, 44, 63, 64, 65, 66, 67, 68]. For example, a study in which 244 asymptomatic young males underwent MRI found that the 67 participants with cam lesions had increased occurrence of labral lesions, impingement pits, and labral deformities [64].…”

Section: Etiology and Risk Factors For Hip Oamentioning

confidence: 99%

Hip Osteoarthritis: Etiopathogenesis and Implications for Management

2016

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Highly prevalent among the elderly, hip osteoarthritis (OA) carries a heavy burden of disease. Guidelines for the management of hip OA are often extrapolated from knee OA research, despite clear differences in the etiopathogenesis and response to treatments of OA at these sites. We propose that hip OA requires specific attention separate from other OA phenotypes. Our understanding of the etiopathogenesis of hip OA has seen significant advance over the last 15 years, since Ganz and colleagues proposed femoroacetabular impingement (FAI) as an important etiological factor. This narrative review summarizes the current understanding of the etiopathogenesis of hip OA and identifies areas requiring further research. Therapeutic approaches for hip OA are considered in light of the condition’s etiopathogenesis. The evidence for currently adopted management strategies is considered, especially those approaches that may have disease-modifying potential. We propose that shifting the focus of hip OA research and public health intervention to primary prevention and early detection may greatly improve the current management paradigm.

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“…Over the last 15 years there has been an exponential growth in the arena of hip preservation surgery (both open and arthroscopic) in young adults in an attempt to prevent degenerative changes and perhaps delay or abort the need for arthroplasty in these patients. The evidence to support this theory has been growing steadily with a recent systematic review looking at 35 studies published between 2003 and 2014 investigating the relationship between FAI and OA [13]. The authors’ looked at all the human studies with more than five patients published since 2000.…”

Section: Does Fai Contribute To the Development Of Hip Osteoarthritismentioning

confidence: 99%

“…This in itself shows that although the number of procedures and even numbers of studies are increasing, there is still a lack of high-quality evidence in order to support or refute the mechanical theory. In this systematic review, the majority of studies used radiological criteria alone to make the diagnosis of FAI [13]. The authors’ concluded that there was a correlation found between FAI and OA, and an alpha angle of >60° was a predisposing factor to the development of significant OA which may then require a THR.…”

Section: Does Fai Contribute To the Development Of Hip Osteoarthritismentioning

confidence: 99%

“…An increased alpha angle of greater than 60° in the presence of FAI has a correlation with OA [13]. Patients with signs on AP radiographs of morphological abnormalities, particularly the presence of posterior wall sign and reduced medial proximal femoral angle, also have increased odds of arthritic progression [19].…”

Section: What Are the Goalposts In The Mildly Arthritic Hip?mentioning

confidence: 99%

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Can hip arthroscopy in the presence of arthritis delay the need for hip arthroplasty?

Viswanath

Khanduja

2017

Journal of Hip Preservation Surgery

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Hip arthroscopy for joint preservation surgery has grown immensely over the last two decades. There is now an increasing trend to try and expand the role of hip arthroscopy to include patients of an older age or perhaps even with signs of arthritis, instead of the established patient group of young adults with mechanical symptoms or serious athletes. But how much of this growth is really justified? Once arthritis is apparent, the arthroscopic procedures needed to try and limit progression of the disease are likely to be different to those needed in young adult non-arthritic hips. Similarly, the expectation of results following an arthroscopic procedure in an older adult with arthritis must also be different. With an almost 5-fold increase in conversion rate from arthroscopy to arthroplasty in the over 50s population, arthroscopy in arthritis is a different procedure, with a different outcome, to arthroscopy in young adults with no evidence of osteoarthritis. This article takes a closer inspection at outcomes following hip arthroscopy in the older population particularly in those with evidence of early arthritis. This paper does not attempt to make recommendations in other diagnoses such as inflammatory arthritis or other secondary arthritides. It must be considered that hip arthroscopy is not a benign intervention: as well as the surgical risks, the lengthy rehabilitation period should be factored into the equation. Although the nature of surgeons is to find new techniques and push boundaries, we highlight the need for caution in undertaking arthroscopic intervention when arthritis is already apparent at presentation.

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Does Femoroacetabular Impingement Contribute to the Development of Hip Osteoarthritis? A Systematic Review

Cited by 80 publications

References 46 publications

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement

Hip Osteoarthritis: Etiopathogenesis and Implications for Management

Can hip arthroscopy in the presence of arthritis delay the need for hip arthroplasty?

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