Medium-term results of arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of femoroacetabular impingement syndrome: a multi-centre randomised controlled trial

Review written by Diogo Gomes info

Key Points

  1. 3 years after treatment, hip arthroscopy provides greater effect in symptom reduction when compared to physiotherapy.
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BACKGROUND & OBJECTIVE

Femoroacetabular impingement (FAI) syndrome is a common cause of hip-related pain, characterised by altered femoral (cam morphology) and/or acetabular (pincer morphology) bone shape which results in premature bony contact and pain during movement (1).

Physiotherapist-led interventions are often considered as first-line treatment for FAI syndrome, aiming to improve hip pain and function. If physiotherapy interventions are not effective, hip arthroscopy surgery is often indicated (2). The aim of the surgery is to reshape the hip to reduce impingement symptoms and prevent hip osteoarthritis development. Both interventions (physiotherapy and arthroscopy) are effective for treating FAI syndrome in the short term (with slight superiority for hip arthroscopy) (2). However, the long-term effects on symptoms and the progression of hip OA remains unclear.

This study reported the 3-year follow up from the FAI Trial, which compared hip arthroscopy surgery with physiotherapy for the treatment of FAI syndrome for the outcomes of hip OA progression and hip pain.

Physiotherapist-led interventions are often considered as first-line treatment for FAI syndrome, aiming to improve hip pain and function.
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Patients should be informed about the risks and benefits of arthroscopic surgery and that the primary goal of surgery should be symptom improvement rather than osteoarthritis prevention.

METHODS

Interventions Adults between 18 and 60 years of age with FAI syndrome were randomised to receive hip arthroscopy surgery or physiotherapy and activity modification. The physiotherapy treatment was tailored to individual patients’ needs and desired level of function, focusing on

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