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Review
. 2022 Oct 2;11(19):5852.
doi: 10.3390/jcm11195852.

Conservative vs. Surgical Management for Femoro-Acetabular Impingement: A Systematic Review of Clinical Evidence

Giuseppe Anzillotti  1   2 , Alberto Iacomella  1   2 , Matteo Grancagnolo  1   2 , Enrico Maria Bertolino  1   2 , Maurilio Marcacci  1   2 , Cristiano Sconza  1   2 , Elizaveta Kon  1   2 , Berardo Di Matteo  1   2
Affiliations
Review

Conservative vs. Surgical Management for Femoro-Acetabular Impingement: A Systematic Review of Clinical Evidence

Giuseppe Anzillotti et al. J Clin Med. .

Abstract

Femoro-acetabular impingement (FAI) syndrome is one of the most studied conditions in sports medicine. Surgical or conservative approaches can be proposed for treating FAI, although the best standard of care is not established yet. Our aim is to provide a comprehensive review of the best treatment for FAI syndrome evaluating differences in outcomes between surgical and non-operative management. A literature search was carried out on the PubMed, EMBASE, Scopus, and PEDro databases, using the following keywords: "femoroacetabular impingement", "FAI", in association with "surgery", "arthroscopy", "surgical" and "conservative", "physiotherapy", "physical therapy", "rehabilitation", "exercise". Only Level I RCTs were included. Four articles were selected for this systematic review. Our analysis showed different therapeutic protocols, follow-up periods, and outcomes; however, three out of the four studies included favored surgery. Our study demonstrates beneficial effects for both arthroscopic treatment and a proper regimen of physical therapy, nevertheless a surgical approach seemed to offer superior short-term results when compared to conservative care only. Further trials with larger sample sizes and longer follow-ups are needed to assess the definitive approach to the FAI condition.

Keywords: arthroscopy; cam; femoro-acetabular impingement; hip; physical therapy; pincer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a). FAI Cam type (b). FAI Pincer type (c). α angle in a lateral view: line 1 passing from the center of the femoral head to the center of the femoral neck and line 2 passing from the center of the femoral head to a point where the distance from the bone to the center of the head is greater than the radius of the cartilage covered femoral head.
Figure 2
Figure 2
PRISMA Flowchart summarizing the selection process.
See this image and copyright information in PMC

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