A review of management options of femoroacetabular impingement

Abstract

s / Osteoarthritis and Cartilage 23 (2015) A82eA416 A333 534 A REVIEW OF MANAGEMENT OPTIONS OF FEMOROACETABULAR IMPINGEMENT J. Fairley, A. Teichtahl, Y. Wang, A. Wluka, S. Brady, F. Cicuttini. Monash Univ., Melbourne, Australia Purpose: Femoroacetabular impingement (FAI) is a common cause of hip pain treated surgically. However, the comparative efficacy of surgery versus non-surgical management is unclear. This review examines the evidence for surgical and non-surgical treatment for FAI using symptoms, hip shape and cartilage change as clinical endpoints. Methods: Electronic searches of MEDLINE and EMBASE were performed to identify relevant studies published from 2000 to July 2014.Studies that met a set of predefined criteria were included. Surgical management strategies (arthroscopy, surgical hip dislocation, combined and miniopen techniques) and non-surgical management (non-surgical, conservative) were searched with “Femoroacetabular Impingement.” Studies reporting outcomes (symptoms and anatomical change) were selected. Results: Sixteen studies comparingmanagement strategies for FAI were identified. Two studies examined non-surgical therapy prior to proceeding to surgical management. Thirteen studies examined symptom outcomes, while nine studies examined the effect on hip shape. Two studies examined impact on cartilage change. Symptom outcomes improved with both surgical and non-surgical treatment. Non-surgical management (anti-inflammatory medications, physiotherapy, activity modification) demonstrated good efficacy over 2 years with an average of 63% in the 2 studies avoiding escalation to surgery. There was no difference in symptom outcomes between surgical techniques (arthroscopy and surgical hip dislocation). Non-surgical therapy had no effect on hip shape while surgical procedures (both open and arthroscopic) resulted in improved, but not normalised, hip shape. Neither of the two studies examining cartilage effects showed any benefit of surgery. Conclusions: There are no studies that have directly compared nonsurgical and surgical treatment for FAI. When non-surgical management is used, approximately two thirds of patients do not proceed to surgery. Factors which predispose surgery have not been investigated. While with surgical intervention hip shape improves, impact on progression of joint degeneration is unclear. Further work addressing these will be needed in order to optimise patient outcome in FAI. 535 UNDERSTANDING FEAR OF MOVEMENT AND REINJURY WITH THE TAMPA SCALE OF KINESIOPHOBIA (TSK) IN INDIVIDUALS WITH MUSCULOSKELETAL KNEE PATHOLOGY: A SYSTEMATIC REVIEW L.M. Thoma y, K. Wolf y, L. Harris z, T. Best y, D. Flanigan y, L. Schmitt y. y The Ohio State Univ., Columbus, OH, USA; zOhio Univ., Columbus, OH,