Femoroacetabular impingement syndrome—efficacy of surgical treatment with regards to age and basic diagnosis

Chládek, P; Musálek, Martin; Trč, Tomáš; Zahradník, Petr; Kos, Petr

doi:10.1007/s00264-014-2574-9

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…However, it is yet not clear whether FAI represents a normal variant in older patients or whether it is a condition associated with severe and aggressive arthritis even in older patients. Because some studies describe surgical interventions for FAI not only for young athletes, but also for older people [13,41,54], it is important to study patients of all ages who have radiographic signs of FAI and also to evaluate the association of FAI with pain and arthrosis in an older community-based cohort. We found that radiographic signs of FAI are common in older men and that the different types of FAI were not associated with increased pain and in fact that patients with cam-type FAI had a slightly lower risk of pain.…”

Section: Discussionmentioning

confidence: 99%

“…In young adults, FAI can be associated with severe arthroscopic degeneration of the hip, whereas in older age groups, it can be a normal variant. In addition, there are now a number of reports that describe surgery for FAI in older people (older than 50 years of age) [7,13,26,41]. Therefore, it is critical to study the complete spectrum of FAI, including in older patients, as well as its association with pain and arthritis.…”

Section: Introductionmentioning

confidence: 99%

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Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study

Nardo

Parimi

Liu

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background The epidemiology of femoroacetabular impingement (FAI) is important but incompletely understood, because most reports arise from symptomatic populations. Investigating the prevalence of FAI in a community-based cohort could help us better understand its epidemiology and in particular the degree to which it might or might not be associated with hip pain.Questions/purposes The purposes of this study were (1) to evaluate the proportion of older (C 65 years of age) men with morphologic abnormalities consistent with FAI; and (2) to assess the association of the morphologic abnormalities with prevalent radiographic hip osteoarthritis (OA) and hip pain. Methods Anteroposterior radiographs were obtained in 4140 subjects (mean age ± SD, 77 ± 5 years) from the Osteoporotic Fractures in Men study. We assessed each hip for cam, pincer, and mixed FAI types using validated radiographic definitions. Both intra-and interobserver reproducibility were [ 0.9. Radiographic hip OA was assessed by an expert reader (intraobserver reproducibility, 0.7-0.8) using validated methods, and summary grades of 2 or greater (on a scale from 0 to 4) were used to define radiographic hip OA. Covariates including hip pain in the last 30 days were collected by questionnaires that were answered by all patients included in this report. Logistic regressions with generalized estimating equations were performed to evaluate the association of radiographic features of FAI and arthrosis. Results Pincer, cam, or mixed types of radiographic FAI had a prevalence of 57% (1748 of Conclusions FAI is common in older men and represents more of an anatomic variant rather than a symptomatic disease. This finding should raise questions on how age, activities, and this anatomic variant each contribute to result in symptomatic disease. Level of Evidence Level III, prognostic study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study

Nardo

Parimi

Liu

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…13 The two main reasons cited to support surgical intervention are the correction of morphological changes and the prevention of intra-articular injury. 14 However, the number of randomized controlled trials of high methodological quality that support the effectiveness of surgery for femoroacetabular impingement syndrome is limited. 15,16 Therefore, it is suggested that clinicians and patients should be cautious when choosing approaches, and non-surgical treatment should be considered.…”

Section: Introductionmentioning

confidence: 99%

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

Bastos

Júnior²,

Silva

et al. 2020

Clin Rehabil

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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 weeks, MD of 5.53 points (95% CI –3.11 to 14.16) at 12 weeks, 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

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“…Morphological correction and prevention of hip osteoarthritis are 2 primary reasons given to support surgical intervention. 9 Improvement of motor control and strengthening of the dynamic stabilizing muscles of the hip and pelvis provide a rationale for nonsurgical treatment. 7,27,53,54…”

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confidence: 99%

Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up

et al. 2018

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Femoroacetabular impingement syndrome—efficacy of surgical treatment with regards to age and basic diagnosis

Abstract: The results of the study affirm the relevance of hip preserving surgery, especially in younger-aged groups.

Cited by 10 publications

References 24 publications

Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study

Femoroacetabular Impingement: Prevalent and Often Asymptomatic in Older Men: The Osteoporotic Fractures in Men Study

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

Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up

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