Arthroscopy of femoroacetabular impingement and osteoarthritis: a systematic review.
BACKGROUND AND PURPOSE Although studies suggested an association between patient factors and various outcome measures in the surgical management of femoroacetabular impingement (FAI), there is a lack of consistent evidence of the influence of osteoarthritis (OA) in patients with FAI syndrome treated arthroscopically. This systematic review investigated the influence of OA on the outcome of arthroscopy for FAI. METHODS The present systematic review followed the PRISMA statement. Web of Science, PubMed, and Embase were accessed in June 2024. All the clinical investigations comparing the outcomes of arthroscopic FAI in patients with different OA stages according to the Tönnis classification were included. MAIN FINDINGS Data from 1421 patients were retrieved, 52% of whom (552 of 1061) were women. The mean follow-up was 53.5 ± 34.5 months. The mean age was 37.5 ± 9.3 years, and the mean BMI was 25.7 ± 2.2 kg/m2. No significant difference was evidenced in visual analogue scale (VAS), modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score - Activities of Daily Living (HOS-ADL), and modified Hip Outcome Score - Sport-Specific Subscale (HOS-SSS), rate of reoperation (P = 0.2), but a higher rate of progression to THA was evidenced in the groups with more advanced OA stages (P < 0.001). CONCLUSIONS The clinical outcomes of patients who underwent arthroscopic surgery for FAI with Tönnis stages 0, I, or II were similar at approximately 54 months of follow-up. However, a higher rate of progression to THA was evidenced in the groups with more advanced OA.