Prevalence of femoro-acetabular impingement in non-arthritic patients with hip pain: a meta-analysis
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ORIGINAL PAPER
Prevalence of femoro-acetabular impingement in non-arthritic patients with hip pain: a meta-analysis Julio J. Jauregui 1
&
Harold I. Salmons 2
&
Sean J. Meredith 1 & Brittany Oster 1 & Rohan Gopinath 1 & Farshad Adib 1
Received: 13 May 2020 / Accepted: 15 October 2020 # SICOT aisbl 2020
Abstract Purpose As the prevalence of femoro-acetabular impingement syndrome (FAIS) in symptomatic patients who lack evidence of hip osteoarthritis (OA) remains to be described, the purpose of this study was to calculate the prevalence of FAIS in this patient population. Methods Libraries of PubMed, Embase, and Ovid were systematically reviewed for all studies between 2009 and 2019, investigating femoro-acetabular impingement and hip pain. Level I–IV studies delineating patients with hip pain who do not have OA (Tonnis or Outerbridge grades < three) were included. Demographics, outcomes, radiographic parameters, and criteria were entered into a meta-analysis to calculate the incidence of FAIS in non-arthritic symptomatic hips. Results In total, 2264 patients (2758 hips) were included in the pooled analysis. Weighted mean age was 31 years. The incidence of FAIS in patients with no evidence of osteoarthritis but who complain of hip pain is 61% (47.3–74.4%). In total, 1483 hips were diagnosed with FAIS. Of the studies that described the rates of all three of the various subtypes of FAIS in their reports, 37% had a combined-type, 38% had a cam-type, and 25% had a pincer-type FAIS. Conclusion Femoroacetabular impingement should be suspected in 47 to 74% of patients with hip pain and without arthritis. Physicians must maintain a high index of suspicion for FAIS in young patients presenting with hip pain, as FAIS is a common and treatable condition that, if left alone, may lead to hip degeneration. Keywords Hip/pelvis/thigh . Femoro-acetabular impingement . Hip arthroscopy . Hip pain
Introduction As a disorder of the proximal femur and acetabular interface, femoro-acetabular impingement syndrome (FAIS), if left untreated, can interfere with hip biomechanics and lead to the progression of hip pain [1, 2] and early hip degeneration [3, 4]. Unfortunately, diagnosing young patients with FAIS remains a challenge, as symptoms frequently overlap with those due to alternative musculoskeletal etiologies [5, 6]. Consequently, misdiagnoses of hip pain can occur in up to 50% of symptomatic patients [7] with delays in diagnosis, reaching up to two years [2, 8]. As a disease that is predominately found in younger, active patients [9], the early identification of FAIS is * Farshad Adib [email protected] 1
Department of Orthopaedics, University of Maryland School of Medicine, 110 Paca Street, Baltimore, MD 21201, USA
2
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
crucial to initiate prompt treatment to alleviate symptoms and return to activity levels, as well as potentially alter the natural history and limit hip degeneration. Understanding the prevalence of FAIS in young symptomatic patients is an es
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