Abstract
Abstract
Objectives
Outcomes following different types of surgical intervention for FAI are well reported individually but comparative data is deficient. The purpose of this study was to conduct a systematic review (SR) and meta-analysis to analyse the outcomes following surgical management of FAI by hip arthroscopy (HA), anterior mini open approach (AMO) and surgical hip dislocation (SHD).
Methods
This SR was registered with PROSPERO. An electronic database search of Pubmed, Medline and EMBASE for English and German language articles over the last 20 years was carried out according to the PRISMA guidelines. We specifically analysed and compared changes in patient reported outcome measures PROMs, α-angle, rate of complications, rate of revision and conversion to total hip arthroplasty (THA).
Results
A total of 48 articles included for final analysis with a total of 4384 hips in 4094 patients. All subgroups showed a significant correction in mean alpha angle post-operatively with a mean change of 28.8° (95% CI, 21°-36.5°; p <0.01) after AMO, 21.1° (95% CI, 15.1°-27°; p <0.01) after SHD and 20.39° (95% CI, 15.66°-25.12°; p <0.01) after HA. AMO group showed a significantly higher increase in PROMs (3.7; 95% CI, 3.2–4.2; p <0.01) versus arthroscopy (2.47; 95% CI, 2.22–2.73; p <0.01) and SHD (2.4; 95% CI, 1.5–3.3; p <0.01). However, the rate of complications following AMO was significantly higher than HA and SHD.
Conclusion
All three surgical approaches offered significant improvements in outcomes and radiological correction of cam deformities. All three groups showed similar rates of revision procedures and SHD had the highest rate of conversion to a THA. Revision rates was similar for all three revision procedures.
