Stefan Fickert1,2, Stefan Landgraeber3. 1. Sporthopaedicum Straubing - Berlin - Regensburg - München, Bahnhofplatz 27, 94315, Straubing, Deutschland. fickert@sporthopaedicum.de. 2. Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland. fickert@sporthopaedicum.de. 3. Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Homburg, Deutschland.
Abstract
BACKGROUND: The treatment of femoroacetabular impingement syndrome (FAIS) and its sequelae has changed over the past 20 years based on a steadily increasing understanding of the condition and improvements in surgical techniques. QUESTION: What is the evidence for the treatment of FAIS? METHODS: Analysis of the available literature, structured review, and discussion of the relevant literature. RESULTS: The treatment of FAIS has evolved over time through several phases. In the first phase, the clinical picture and its open treatment by surgical hip dislocation were described. Subsequently, the first comparative studies between open, mini-open, and arthroscopic therapy were published. After development of disease-specific patient-reported outcome measurement systems, the concerns of the young, more active patient population could be captured. In recent years, prospective randomized controlled trials comparing conservative versus surgical therapy of FAIS have been published, showing the superiority of surgical treatment and also the need to strengthen evidence-based research especially in the field of conservative treatment of FAIS. CONCLUSION: The pathomechanism and sequelae of FAIS have been increasingly studied scientifically in recent years. The superiority of a particular surgical technique cannot be demonstrated; the arthroscopic technique has a lower complication rate and a faster convalescence. Clinically important outcome measures are also becoming increasingly established in the therapy of FAIS to capture the clinical relevance for the individual.
BACKGROUND: The treatment of femoroacetabular impingement syndrome (FAIS) and its sequelae has changed over the past 20 years based on a steadily increasing understanding of the condition and improvements in surgical techniques. QUESTION: What is the evidence for the treatment of FAIS? METHODS: Analysis of the available literature, structured review, and discussion of the relevant literature. RESULTS: The treatment of FAIS has evolved over time through several phases. In the first phase, the clinical picture and its open treatment by surgical hip dislocation were described. Subsequently, the first comparative studies between open, mini-open, and arthroscopic therapy were published. After development of disease-specific patient-reported outcome measurement systems, the concerns of the young, more active patient population could be captured. In recent years, prospective randomized controlled trials comparing conservative versus surgical therapy of FAIS have been published, showing the superiority of surgical treatment and also the need to strengthen evidence-based research especially in the field of conservative treatment of FAIS. CONCLUSION: The pathomechanism and sequelae of FAIS have been increasingly studied scientifically in recent years. The superiority of a particular surgical technique cannot be demonstrated; the arthroscopic technique has a lower complication rate and a faster convalescence. Clinically important outcome measures are also becoming increasingly established in the therapy of FAIS to capture the clinical relevance for the individual.