Is surgery effective in patients with femoroacetabular impingement syndrome?

Femoroacetabular impingement syndrome (FAIS) describes motion related hip pain, which is caused by premature bony contact between deformities at the femoral neck and/or the acetabular rim123 (fig 1). Young, active adults are commonly affected. A prospective study in the Netherlands found that 17% of adults presenting to primary care with hip/groin pain in a year (84 adults in all) were subsequently diagnosed with FAIS on radiological imaging,4 and a further 30% had a high clinical suspicion. Impingement can damage the joint cartilage over time and lead to osteoarthritis.2356

Treatment includes conservative care with analgesics, lifestyle and activity modification, and physiotherapy, or surgery. Attempts to refine diagnostic and treatment criteria have been made;7 however, doubt remains about subcategories of FAIS and subgroup outcomes.89 Yet, the volume of arthroscopic hip surgery has grown exponentially.10 FAIS is the primary indication for this surgery.11 Within the past decade, the number of hip arthroscopies performed in the NHS has increased 10-fold. Almost 4000 surgeries are predicted annually by 2023.10 Controversy exists about how …