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European Journal of Orthopaedic Surgery & Traumatology

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Open Access 01-10-2020 | Arthroscopy | Review Article

Arthroscopic surgery versus physiotherapy for femoroacetabular impingement: a meta-analysis study

Authors: Matthias Gatz, Arne Driessen, Jörg Eschweiler, Markus Tingart, Filippo Migliorini

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 7/2020

Abstract

Introduction

Femoroacetabular impingement (FAI) is thought to play an important role in the development of hip osteoarthritis. However, there is no consensus about the optimal treatment options, since non-operative therapy such as physiotherapy and surgical treatment such as arthroscopic hip surgery can both improve symptoms. Therefore, the aim of the present meta-analysis was to compare the outcomes between two different treatment regimes; physiotherapy versus arthroscopic treatment for FAI.

Methods

The present meta-analysis was carried out according to the PRISMA guidelines. In November 2019, the main online databases were accessed. All the randomized clinical trials (RCTs) comparing surgical arthroscopic treatment versus physiotherapy for FAI were considered for inclusion. Only articles reporting quantitative data under the outcomes of interest were included. For the all analysis, we used Review Manager Software. Data from 644 patients were analysed.

Results

Data from 644 patients were evaluated with a mean follow-up of 14.67 ± 8.3 months. The unpaired t test detected an optimal baseline comparability in terms of side, gender, years, duration of symptoms and BMI (p = 0.08–0.9). The VAS subscale of the score EQ-5D and the mean iHOT33 reported favourable values in the arthroscopic group (p = 0.03 and p < 0.0001, respectively). Similar findings were evidenced in the iHOT33 subgroup 6-months (p = 0.70) and 12-months (p = 0.0002). The HOS score, the ADL (p < 0.0001) and the sport (p = 0.0003) subscales reported both greater values in the arthroscopic group. No statistical significance was found concerning the risk to incur in further total hip arthroplasty (p = 0.72).

Conclusion

Based on only three high-quality RCTs, arthroscopic hip surgery is an effective therapeutic treatment for FAI revealing superior results than a non-surgical approach with physiotherapy.

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Title: Arthroscopic surgery versus physiotherapy for femoroacetabular impingement: a meta-analysis study
Authors: Matthias Gatz
Arne Driessen
Jörg Eschweiler
Markus Tingart
Filippo Migliorini
Publication date: 01-10-2020
Publisher: Springer Paris
Keywords: Arthroscopy
Femuroacetabular Impingement
Arthroscopy
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 7/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-020-02675-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Arthroscopic surgery versus physiotherapy for femoroacetabular impingement: a meta-analysis study

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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