Efficacy and safety of arthroscopy in femoroacetabular impingement syndrome: A systematic review and meta-analysis

Abstract

Abstract The aim of this study was to compare, in terms of efficacy and safety, arthroscopy with physiotherapy or joint lavage in patients with femoroacetabular impingement (FAI). A meta-analysis using PubMed, Embase, Scopus, and the Cochrane Collaboration Library database was carried out in September 2022. We included studies focusing on patients with FAI undergoing arthroscopic surgery versus physiotherapy or arthroscopic lavage. Outcomes were functional scores (iHOT-33 and HOS ADL) and adverse events. We included randomized clinical trials. Data was combined using Review Manager 5.4. (PROSPERO: CRD42022375273). A total of six RCTs were included from a pool of 839 patients (407 females). iHOT-33 and HOS ADL scales showed significant differences at 12 months in favour of the arthroscopy group (MD 10.65; 95% CI; 6.54–4.76) and (MD 8.09; 95% CI; 3.11–13.07). MCID was not achieved through arthroscopy in functional variables. The rate of osteoarthritis (OR 6.18; 95% CI; 1.06–36.00) and numbness (OR 73.73; 95% CI; 10.00-43.92) was significantly high in the arthroscopy group. Arthroscopic surgery showed statistical superiority over the control group without exceeding MCID in most studies; however, the results might have been influenced by secondary variables. Finally, arthroscopic surgery showed a high rate of conversion to osteoarthritis.