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Outcome of Surgical Treatment of Hip Femoroacetabular Impingement Patients with Radiographic Osteoarthritis

A Meta-analysis of Prospective Studies

Lei, Pengfei, MD; Conaway, William K., BA; Martin, Scott D., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: January 15, 2019 - Volume 27 - Issue 2 - p e70–e76
doi: 10.5435/JAAOS-D-17-00380
Research Article

Introduction: In this study, the prognostic value of osteoarthritis (OA) on the overall failure rate, pain, and function of surgical management of femoroacetabular impingement (FAI) was evaluated via meta-analysis.

Methods: Relevant comparative studies were obtained from PubMed, OVID, and Cochrane database up until April 2016. Studies were selected according to the eligibility criteria. The study design, participant characteristics, interventions, and outcomes were reviewed after the assessment of methodological quality of each trial. All data were analyzed by Review Manager 5.3.

Results: Seven studies were identified with 1,129 total patients, with 819 patients in the FAI group and 310 patients in the FAI with OA group. Pooled analyses showed that the overall failure rate was significantly higher in the FAI-OA group than in the FAI group (odds ratio, 8.50; 95% confidence interval, 4.44 to 16.26; P < 0.00001). In addition, the rate of conversion to total hip arthroplasty was significantly higher in the FAI-OA group (37.3%) than in the FAI group (9.7%) (odds ratio, 19.42; 95% confidence interval, 7.00 to 53.85; P < 0.00001).

Conclusions: We found that radiographic OA was correlated with higher failure rates, increased conversion to total hip arthroplasty, and worse outcomes after surgical management of FAI.

Level of Evidence: Level II

From the Department of Orthopaedics, Xiangya Hospital, Central South University, Hunan Province, China (Dr. Lei), the Department of Orthopaedics, Massachusetts General Hospital, Boston, MA, the Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA, and the Department of Orthopaedics, Harvard Medical School, Boston, MA (Dr. Lei, Mr. Conaway, Dr. Martin).

Correspondence to Dr. Lei:

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Lei, Mr. Conaway, and Dr. Martin.

© 2019 by American Academy of Orthopaedic Surgeons
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