Auswahl des Operationsverfahrens beim Femoroazetabulären Impingement-Syndrom

Predicting Outcomes in Hip Arthroscopy for Femoroacetabular Impingement Syndrome

PURPOSE OF REVIEW

Arthroscopic treatment of femoroacetabular impingement syndrome (FAIS) continues to rise in incidence, and thus there is an increased focus on factors that predict patient outcomes. The factors that impact the outcomes of arthroscopic FAIS treatment are complex. The purpose of this review is to outline the current literature concerning predictors of patient outcomes for arthroscopic treatment of FAIS.

RECENT FINDINGS

Multiple studies have shown that various patient demographics, joint parameters, and surgical techniques are all correlated with postoperative outcomes after arthroscopic FAIS surgery, as measured by both validated patient-reported outcome (PRO) scores and rates of revision surgery including hip arthroplasty. To accurately predict patient outcomes for arthroscopic FAIS surgery, consideration should be directed toward preoperative patient-specific factors and intraoperative technical factors. The future of accurately selecting patient predictors for outcomes will only improve with increased data, improved techniques, and technological advancement.

[Results after FAIS surgery-what is the evidence?]

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.