What is it about?

We currently don't know the optimal treatment approach for femoroacetabular impingement (FAIS). As our understanding of this diagnosis improves, both surgical procedures and non-surgical management approaches continue to evolve. While surgical correction is very popular, no clinical trials to date have compared surgical to non-surgical interventions. This study set out to look at differences in 2-year outcomes between patients randomized to receive either one of these treatments.

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Why is it important?

Often patients are educated on the value of each of these treatments. However, since they have never been compared, it is challenging to inform patients when they want to know which option is the best. If one is clearly the optimal choice, then this research can help patients make an appropriately informed decision. Unfortunately, these results do not definitively answer the question, but rather keep the conversation moving. Much work still needs to be done to identify who is best for surgery and who is best for conservative rehab. It's like not an either/or.

Perspectives

Its important to consider that these were patients in the Military Health System (including service members and their families), and may not be generalizable to other settings. These types of trials are very challenging, as it's only possible really for one side to cross over. In this case, many patients did cross over to have surgery....but they weren't necessarily better off afterwards. Unfortunately, we'll need more studies in larger and more diverse cohorts of patients before this question can be adequately answered.

Daniel Rhon
Brooke Army Medical Center

Read the Original

This page is a summary of: Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up, The American Journal of Sports Medicine, February 2018, SAGE Publications,
DOI: 10.1177/0363546517751912.
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