Operative Versus Nonoperative Treatment of Femoroacetabular Impingement Syndrome: A Meta-analysis of Short-Term Outcomes

Dwyer, Tim; Whelan, Daniel B.; Shah, Prakesh S.; Ajrawat, Prabjit; Hoit, Graeme; Chahal, Jaskarndip

doi:10.1016/j.arthro.2019.07.025

Cited by 61 publications

(59 citation statements)

References 61 publications

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“…These questions should then inform the shared decision between patient and clinician on what sort of treatment is most appropriate for that individual. The recent review by Dwyer et al 4 attempted to answer the following questions: What are the likely outcomes of surgery compared with nonsurgical treatment, and what is the costeffectiveness of surgery? However, we need to look to other studies outside the scope of this review to gain answers to all the aforementioned questions.…”

Section: See Commentary On Page 263mentioning

confidence: 99%

“…There have been 3 recent randomized clinical trials that looked at outcomes of hip arthroscopy compared with physiotherapist-led treatment. [5][6][7] In their metaanalysis, Dwyer et al 4 significant benefit that favored the hip arthroscopy groups compared with the physiotherapist-led treatment groups (3.46 of 100 points; 95% confidence interval, 0.07 to 6.86 points). Although this difference was statistically significant, Dwyer et al questioned the likely clinical benefit of this small difference.…”

Section: See Commentary On Page 263mentioning

confidence: 99%

“…We do not know about return-to-sport rates with physiotherapist-led treatment, and we still do not have any high-quality, full-scale placebo-controlled clinical trials of physiotherapist-led treatment for FAI syndrome. As Dwyer et al 4 have reported, the optimal type of physiotherapist-led treatment remains unclear, although preliminary evidence suggests exercise-based treatment is likely to be effective. 12,13 I look forward to the publication of clinical trials of physiotherapist-led treatment for FAI syndrome in the future to assist patients and clinicians alike in making informed decisions about which treatment option is best for them.…”

Section: Found a Small Statisticallymentioning

confidence: 99%

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Editorial Commentary: A Commentary on a Meta-analysis of Short-Term Outcomes

Kemp

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Hip pain is prevalent and costly, and young patients with hip femoroacetabular impingement have similar levels of pain and quality of life to older patients with hip osteoarthritis. Hip arthroscopic surgery for femoroacetabular impingement is increasing in prevalence, and the benefits of operative treatment compared with nonoperative treatment require consideration. Hip arthroscopy should not be a first-line treatment but can be necessary in cases in which highquality, exercise-based nonsurgical treatment options have been exhausted. Patients should be informed that surgery is not necessarily cost-effective and may have an increased risk of comorbidities such as chronic pain and insomnia. Patientreported outcomes may improve by up to 20% with either surgery or physical therapy but are not likely to return to those seen in patients without hip pain. Although most patients return to sport after hip arthroscopy, the ability to participate at a preinjury level is seen in fewer than a quarter of patients. Return-to-sport rates with physiotherapist-led nonoperative treatment are not known.

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Section: See Commentary On Page 263mentioning

confidence: 99%

Section: See Commentary On Page 263mentioning

confidence: 99%

Section: Found a Small Statisticallymentioning

confidence: 99%

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Editorial Commentary: A Commentary on a Meta-analysis of Short-Term Outcomes

Kemp

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…The rate of return to sports was 87.7% A correlation was found between shorter time of preoperative symptoms and a higher rate of return to sports. In comparison with physiotherapy treatment, hip arthroscopy presents better results, [31][32][33] fewer complications, although with the same clinical results as surgical dislocation, 9 it provides a higher probability of returning to sports activity and earlier than surgical dislocation. 34,35 The incidence of complications in hip arthroscopy is about 1.5%, 36 with the most common complication being reversible nerve dysfunction.…”

Section: Hip Arthroscopymentioning

confidence: 99%

Impacto femoroacetabular e lesão do lábio acetabular – Parte 3: Tratamento cirúrgico

Queiroz

Junior

Ejnisman

et al. 2020

Rev Bras Ortop (Sao Paulo)

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ResumoNos últimos 15 anos, o diagnóstico do impacto femoroacetabular tem se tornado cada vez mais frequente; com o avanço do entendimento de quais pacientes potencialmente se beneficiariam do tratamento cirúrgico, diferentes técnicas foram desenvolvidas. O tratamento cirúrgico inclui grande variedade de opções, sendo elas: osteotomia periacetabular, técnica de luxação cirúrgica do quadril, artroscopia com osteocondroplastia via pequena incisão, técnica via anterior modificada, e técnica exclusivamente artroscópica. O tipo de abordagem deve ser escolhido de acordo com a complexidade da morfologia do impacto femoroacetabular e com o treinamento do cirurgião. As técnicas mais utilizadas atualmente são a artroscopia, a luxação cirúrgica do quadril e a osteotomia periacetabular. O presente artigo busca descrever as principais técnicas cirúrgicas utilizadas para o tratamento do impacto femoroacetabular, suas indicações, vantagens e desvantagens, complicações e resultados clínicos.

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“…In recent years it has become more widely appreciated that underlying joint shape is a strong risk factor for OA. This realisation has led to an explosion in the use of surgical interventions designed to restore the joint to a more anatomically normal shape and improve mechanical symptoms [9][10][11]. Only time will establish whether such interventions alter the natural history of OA.…”

Section: Introductionmentioning

confidence: 99%

The Genetic Epidemiology of Joint Shape and the Development of Osteoarthritis

Wilkinson¹,

Zeggini²

2020

Calcif Tissue Int

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Congruent, low-friction relative movement between the articulating elements of a synovial joint is an essential prerequisite for sustained, efficient, function. Where disorders of joint formation or maintenance exist, mechanical overloading and osteoarthritis (OA) follow. The heritable component of OA accounts for ~ 50% of susceptible risk. Although almost 100 genetic risk loci for OA have now been identified, and the epidemiological relationship between joint development, joint shape and osteoarthritis is well established, we still have only a limited understanding of the contribution that genetic variation makes to joint shape and how this modulates OA risk. In this article, a brief overview of synovial joint development and its genetic regulation is followed by a review of current knowledge on the genetic epidemiology of established joint shape disorders and common shape variation. A summary of current genetic epidemiology of OA is also given, together with current evidence on the genetic overlap between shape variation and OA. Finally, the established genetic risk loci for both joint shape and osteoarthritis are discussed.

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Operative Versus Nonoperative Treatment of Femoroacetabular Impingement Syndrome: A Meta-analysis of Short-Term Outcomes

Cited by 61 publications

References 61 publications

Editorial Commentary: A Commentary on a Meta-analysis of Short-Term Outcomes

Editorial Commentary: A Commentary on a Meta-analysis of Short-Term Outcomes

Impacto femoroacetabular e lesão do lábio acetabular – Parte 3: Tratamento cirúrgico

The Genetic Epidemiology of Joint Shape and the Development of Osteoarthritis

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