Femoroacetabular Impingement Syndrome - Outcomes of Arthroscopic Hip Surgery

Abstract

Hip and groin problems are common among young, active individuals. Femoroacetabular impingement (FAI) syndrome is an important cause of hip pain and reduced hip function among these patients. Bony abnormalities at the femoral head and neck junction and/or the acetabular rim may result in abnormal contact between these structures. Recent advancements in hip arthroscopy have made it possible to treat this condition using a minimally invasive approach and this is currently the standard procedure. The initial results of the treatment have been promising and there is emerging scientific evidence of promising outcomes at long-term follow-ups.

The aim of this thesis is to evaluate medium- to long-term outcome, and predictors of outcome in patients undergoing arthroscopic treatment for FAI syndrome, and to evaluate the methodological quality of the current evidence for this treatment.

Study I is a prospective cohort study comprising 289 patients, evaluating the outcome of arthroscopic treatment for FAI syndrome at a two-year follow-up using patient-reported outcome measurements (PROMs). A significant and clinically relevant improvement was noted.

Study II is a retrospective cohort study comprising 198 patients, evaluating predictors of treatment outcome at a two-year follow-up using multiple linear regression analysis. Greater preoperative patient-reported hip function was associated with a higher postoperative patient-reported hip function.

Study III is a cross-cultural adaptation and validation of a PROM to evaluate the level of physical activity. The Swedish version was deemed to be a reliable and valid measurement to determine the level of physical activity in patients with FAI syndrome.

Study IV is a systematic review evaluating the methodological quality of prospective cohort studies of arthroscopic treatment for FAI syndrome. A total of 53 studies were included and the methodological quality of the included studies was deemed to be of moderate quality for both non-comparative and comparative studies.

Study V is a prospective cohort study comprising 184 patients, evaluating the outcome of arthroscopic treatment for FAI syndrome at a five-year follow-up using PROMs. A significant and clinically relevant improvement was noted.