Surgery for hip impingement (femoroacetabular impingement)

This summary of a Cochrane review presents what we know from research about the effectiveness and safety of surgery for hip impingement (also called femoroacetabular impingement). A search for relevant studies was done on 19th November 2013. The review of the results from this search showed the following.

1. No research studies have been completed that are of sufficient quality to accurately determine the benefit and safety of surgery for femoroacetabular impingement.

2. Four ongoing research studies may help to determine the benefit and safety of femoroacetabular impingement surgery when they are completed.

All of the ongoing research studies are recruiting adult patients with femoroacetabular impingement. Three of these studies are comparing hip arthroscopy versus non-operative care. The fourth study is comparing hip arthroscopy versus a sham arthroscopic hip procedure.

What is femoroacetabular impingement and what is surgery?
Femoroacetabular impingement, or hip impingement, occurs because of subtle abnormalities of hip shape. The abnormalities of hip shape can cause damage to soft tissues around the hip including the cartilage (on the surfaces of the joint), which allows the joint to move freely. Femoroacetabular impingement can cause pain and restrict hip function. Surgery for femoroacetabular impingement can be either arthroscopic (keyhole) or open surgery. The aim of surgery is to correct the hip shape abnormalities and to repair damaged soft tissues and cartilage.

Best estimate of what happens to people with femoroacetabular impingement who have surgery

Until any high quality research studies are available for review it is not possible to provide any estimate of whether surgery helps people with femoroacetabular impingement or not.

Authors' conclusions: 

There is no high quality evidence examining the effectiveness of surgery for femoroacetabular impingement. There are four ongoing studies, which may provide evidence for the benefit and safety of this type of surgery in the future.

Read the full abstract...
Background: 

Surgery is sometimes recommended for femoroacetabular impingement where non-operative interventions have failed.

Objectives: 

To determine the benefits and safety of surgery for femoroacetabular impingement.

Search strategy: 

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 11); MEDLINE (Ovid) (1946 to 19 November 2013); and EMBASE (Ovid) (1980 to 19 November 2013) for studies, unrestricted by language.

Selection criteria: 

Randomised and quasi-randomised clinical trials assessing surgical intervention compared with placebo treatment, non-operative treatment or no treatment in adults with femoroacetabular impingement.

Data collection and analysis: 

Two authors independently selected trials for inclusion, assessed risk of bias and extracted data.

Main results: 

There were no studies that met the inclusion criteria, with 11 studies that were excluded following detailed review. There were four ongoing studies identified that may meet the inclusion criteria when they are completed; the results from these ongoing studies may begin to become available within the next five years. Three of the four ongoing studies are comparing hip arthroscopy versus non-operative care. The fourth study is comparing hip arthroscopy versus a sham arthroscopic hip procedure. All of the ongoing studies are recording at least one of our preferred clinical outcome measures for benefit and safety.

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