X-ref For other Roundups in this issue that cross-reference with Hip & Pelvis see: Trauma Roundups 1, 2, 5 and 6; Oncology Roundup 6; Children’s orthopaedics Roundup 1 and Research Roundup 7.
Hip arthroscopy and the evidence
Although the number of hip arthroscopies undertaken is increasing steadily across the globe, there are still many who doubt the efficacy of this procedure, or even the existence of femoroacetabular impingement (FAI) as a clinical entity. There is no consensus as to the natural history of FAI and the link to osteoarthritis is difficult to quantify, although most now accept it is probably at least a predisposing condition. A review team based in Horsens (Denmark) have conducted a thorough review of the literature and meta-analysis in a very valid attempt to distil the existing literature and shed further light on the value or otherwise of hip arthroscopy for FAI.1 The authors have employed a fairly robust methodology to identify studies of reasonable quality (albeit low level evidence – only one RCT) using EMBASE, MEDLINE, SportsDiscus, CINAHL, the Cochrane Library and PEDro. They were able to identify 26 studies for inclusion in their meta-analysis. A strength of this study over other similar previously published work is that clinical outcome data were included and analysed at different time points following hip arthroscopy, and then compared against pre-operative clinical scores. The key findings were:
- subjective improvement in hip pain detectable between three and six months following surgery
- improvements to activities of daily living between three and six months following surgery
- improvement to sporting function between six and 12 months following surgery
- ongoing improvement in all of these areas continued up until two to three years post-operatively
This study, which is the strongest evidence to date, would suggest that over two thirds of patients are satisfied with the results of …