Conservative versus arthroscopic surgery for treating femoroacetabular impingement: a meta-analysis

LIU Shujing; YU Yingying; MIAO Weicheng; WANG Hao

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Medical Journal of the Chinese People Armed Police Forces ›› 2021, Vol. 32 ›› Issue (12) : 1048-1052.

ORIGINAL ARTICLES

Conservative versus arthroscopic surgery for treating femoroacetabular impingement: a meta-analysis

LIU Shujing¹, YU Yingying², MIAO Weicheng³, WANG Hao³

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Abstract

Objective To compare the clinical effects of arthroscopic surgery and conservative treatment for femoroacetabular impingement via meta-analysis so as to provide evidence-based evidence for clinical treatment of femoroacetabular impingement. Methods Literature on randomized controlled clinical trials of conservative and arthroscopic surgery for femoroacetabular impingement was retrieved from PubMed, Embase, Cochrane Library, China HowNet and Wanfang databases. Meta-analysis was performed using RevMan 5.3 software after rigorous quality evaluation. The clinical indicators included the iHOT-33 score and HOS-ADL score. Results Three articles were included. The meta-analysis results showed that the HOS-ADL score of patients in the arthroscopic surgery group was higher than that of the conservative treatment group (MD=7.80, 95% CI:2.95-12.656, P< 0.05). There was no significant difference in the iHOT-33 score between the two groups (MD=2.35, 95% CI:-12.62-17.33, P>0.05). Conclusions This meta-analysis shows that hip arthroscopic surgery for femoral acetabular impingement syndrome can achieve a higher HOS-ADL score, but there is no significant difference in the iHOT-33 score between the two approaches.

Key words

femoroacetabular impingement / conservative treatment / arthroscopic surgery / meta analysis

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LIU Shujing, YU Yingying, MIAO Weicheng, WANG Hao. Conservative versus arthroscopic surgery for treating femoroacetabular impingement: a meta-analysis[J]. Medical Journal of the Chinese People Armed Police Forces. 2021, 32(12): 1048-1052

References

[1] Arshad Z, Maughan H D, Sunil Kumar K H, et al. Over one third of patients with symptomatic femoroacetabular impingement display femoral or acetabular version abnormalities[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(9): 2825-2836.
[2] Yarwood W, Sunil K K H, Ng K C G, et al. Biomechanics of cam femoroacetabular impingement: a systematic review[J]. Arthroscopy, 2021,17(6): 1526-1528.
[3] Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement: a cause for osteoarthritis of the hip[J]. Clin Orthop Relat Res, 2003, 17(4): 112-120.
[4] Ganz R, Gill T J, Gautier E, et al. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis[J]. J Bone Joint Surg Br, 2001, 83(8): 1119-1124.
[5] Khan M, Ayeni O R, Madden K, et al. Femoroacetabular impingement: have we hit a global tipping point in diagnosis and treatment? Results from the international femoroacetabular impingement optimal care update survey (in focus)[J]. Arthroscopy, 2016, 32(5): 779-787.
[6] Cvetanovich G L, Chalmers P N, Levy D M, et al. Hip arthroscopy surgical volume trends and 30-day postoperative complications[J]. Arthroscopy, 2016, 32(7): 1286-1292.
[7] Palmer A J, Malak T T, Broomfield J, et al. Past and projected temporal trends in arthroscopic hip surgery in England between 2002 and 2013[J]. BMJ Open Sport Exerc Med, 2016, 2(1): 779-787.
[8] Richardson R S, Lothe K, Sturridge S. Is surgery effective in patients with femoroacetabular impingement syndrome?[J]. BMJ, 2019, 3(19):65-69.
[9] Spencer-Gardner L, Dissanayake R, Kalanie A, et al. Hip arthroscopy results in improved patient reported outcomes compared to non-operative management of waitlisted patients[J]. J Hip Preserv Surg, 2017, 4(1): 39-44.
[10] Higgins J P T, Green S. Cochrane handbook for systematic reviews of interventions[M]. Chichester,2008: 649-649.
[11] Mohtadi N G, Griffin D R, Pedersen M E, et al. The development and validation of a self-administered quality-of-life outcome measure for young, active patients with symptomatic hip disease: the international hip outcome tool (iHot-33)[J]. Arthroscopy, 2012, 28(5): 595-605.
[12] Martin R L, Kelly B T, Philippon M J. Evidence of validity for the hip outcome score[J]. Arthroscopy, 2006, 22(12): 1304-1311.
[13] Martin R L, Philippon M J. Evidence of validity for the hip outcome score in hip arthroscopy[J]. Arthroscopy, 2007, 23(8): 822-826.
[14] Martin R L, Philippon M J. Evidence of reliability and responsiveness for the hip outcome score[J]. Arthroscopy, 2008, 24(6): 676-682.
[15] Simunovic N, Heels-Ansdell D, Thabane L, et al. Femoroacetabular impingement randomised controlled trial (first)-a multi-centre randomized controlled trial comparing arthroscopic lavage and arthroscopic osteochondroplasty on patient important outcomes and quality of life in the treatment of young adult (18-50 years) femoroacetabular impingement: a statistical analysis plan[J]. Trials, 2018, 19(1): 588.
[16] Murphy N J, Eyles J, Bennell K L, et al. Protocol for a multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapy-led care for femoroacetabular impingement (FAI): the Australian FASHIoN trial[J]. BMC Musculoskelet Disord, 2017, 18(1): 406.
[17] Mansell N S, Rhon D I, Marchant B G, et al. Two-year outcomes after arthroscopic surgery compared to physical therapy for femoracetabular impingement: a protocol for a randomized clinical trial[J]. BMC Musculoskeletal Disorders, 2016, 17(1):60.
[18] Wall P D, Dickenson E J, Robinson D, et al. Personalised hip therapy: development of a non-operative protocol to treat femoroacetabular impingement syndrome in the FASHIoN randomised controlled trial[J]. Br J Sports Med, 2016, 50(19): 1217-1223.
[19] Palmer A J, Ayyar-Gupta V, Dutton S J, et al. Protocol for the femoroacetabular impingement trial (FAIT): a multi-centre randomised controlled trial comparing surgical and non-surgical management of femoroacetabular impingement[J]. Bone Joint Res, 2014, 3(11): 321-327.
[20] Griffin D R, Dickenson E J, Wall P D, et al. Protocol for a multicentre, parallel-arm, 12-month, randomised, controlled trial of arthroscopic surgery versus conservative care for femoroacetabular impingement syndrome (FASHIoN)[J]. BMJ Open, 2016, 6(8):45-53.
[21] Investigators F. A multi-centre randomized controlled trial comparing arthroscopic osteochondroplasty and lavage with arthroscopic lavage alone on patient important outcomes and quality of life in the treatment of young adult (18-50) femoroacetabular impingement[J]. BMC Musculoskelet Disord, 2015, 16(64):58-62.
[22] Smeatham A, Powell R, Moore S, et al. Does treatment by a specialist physiotherapist change pain and function in young adults with symptoms from femoroacetabular impingement? A pilot project for a randomised controlled trial[J]. Physiotherapy, 2017, 103(2): 201-207.
[23] Mansell N S, Rhon D I, Meyer J, et al. Arthroscopic surgery or physical therapy for patients with femoroacetabular impingement syndrome: a randomized controlled trial with 2-year follow-up[J]. Am J Sports Med, 2018, 46(6): 1306-1314.
[24] Griffin D R, Dickenson E J, Wall P D H, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial[J]. Lancet, 2018, 391(10136): 2225-2235.
[25] Palmer A J R, Ayyar Gupta V, Fernquest S, et al. Arthroscopic hip surgery compared with physiotherapy and activity modification for the treatment of symptomatic femoroacetabular impingement: multicentre randomised controlled trial[J]. BMJ, 2019, 33(9):364-385.
[26] Notzli H P, Wyss T F, Stoecklin C H, et al. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement[J]. J Bone Joint Surg Br, 2002, 84(4): 556-560.
[27] Griffin D R, Dickenson E J, O'donnell J, et al. The warwick agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement[J]. Br J Sports Med, 2016, 50(19): 1169-1176.
[28] Nepple J J, Prather H, Trousdale R T, et al. Diagnostic imaging of femoroacetabular impingement[J]. J Am Acad Orthop Surg, 2013, 21 (1): 20-26.
[29] Nepple J J, Prather H, Trousdale R T, et al. Clinical diagnosis of femoroacetabular impingement[J]. J Am Acad Orthop Surg, 2013, 21(1): 16-19.
[30] Khan M, Bedi A, Fu F, et al. New perspectives on femoroacetabular impingement syndrome[J]. Nat Rev Rheumatol, 2016, 12(5): 303-310.
[31] Peters S, Laing A, Emerson C, et al. Surgical criteria for femoroacetabular impingement syndrome: a scoping review[J]. Br J Sports Med, 2017, 51(22): 1605-1610.
[32] Briggs K K, Bolia I K. Hip arthroscopy: an evidence-based approach[J]. Lancet, 2018, 391(10136): 2189-2190.
[33] Wall P D, Brown J S, Parsons N, et al. Surgery for treating hip impingement (femoroacetabular impingement)[J]. Cochrane Database Syst Rev, 2014, 26(9): 17-26.