Can intra-articular hip injections predict arthroscopy outcomes for femoroacetabular impingement syndrome? A systematic review

Abstract

BackgroundFemoroacetabular Impingement (FAI) syndrome represents a prevalent aetiology of hip discomfort observed among both adolescent and adult populations. It is initially managed conservatively with oral anti-inflammatories and physiotherapy; some patients proceed to receiving an intra-articular (IA) hip injection, but ultimately, the gold-standard treatment is hip arthroscopy. Study designSystematic Review. PurposeTo systematically investigate the relationship between response to IA anaesthetic or steroid hip injections and arthroscopy outcomes for FAI syndrome. MethodsA systematic search of PubMed, Medline, CINAHL, SCOPUS, and Cochrane was conducted in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. ResultsSeven studies (Level II-IV) were identified that met our inclusion and exclusion criteria. These studies collectively included 637 patients, demonstrating an average age of 37.5 years (and a range of 14–72 years). Two of the seven studies reported a statistically significant positive correlation between response to IA injections and arthroscopy outcomes. The remaining five studies found that although a positive IA injection response increased the odds of a good outcome post arthroscopy (defined across various studies as a post-operative modified Harris Hip score of >70 points, >79 points or an improvement by 8 or more points), this correlation was not statistically significant. ConclusionIA hip injections can be a useful prognostic tool, though they are not a consistently reliable predictor of which patients will have good arthroscopic outcomes.