FAI (Femoroacetabular Impingement)

Studies on Techniques for FAI

📌 Systematic Review — A systematic review of literature on femoroacetabular impingement (FAI) surgery found that various surgical techniques, including those by Arthrex, are associated with pain relief and improved function in 68-96% of patients over short-term follow-up.

📊 Evidence Levels — The current evidence regarding FAI surgery is primarily Level IV, indicating that while there are positive outcomes, the strength of clinical evidence is debated and more high-level studies are needed.

🔬 Surgical Techniques — Techniques such as surgical dislocation, periacetabular osteotomy, and arthroscopic methods are used to treat FAI, aiming to relieve pain and preserve hip function.

⚠️ Complications — Major complications in FAI surgeries occur in 0% to 18% of procedures, with conversion to total hip arthroplasty (THA) reported in 0% to 26% of cases.

🩺 Arthroscopic Approach — Arthroscopic techniques, including those by Arthrex, allow for direct visualization of the femoral head-neck junction, avoiding surgical dislocation and reducing complication rates.

💡 "Current evidence regarding femoroacetabular impingement surgery is primarily Level IV and suggests the various surgical techniques are associated with pain relief and improved function in 68-96% of patients over short-term follow-up."

Surgical Techniques

🔹 Arthroscopic Methods — Arthroscopic techniques are minimally invasive and allow for direct visualization of the femoral head-neck junction, reducing the need for surgical dislocation.

🔹 Surgical Dislocation — This technique involves dislocating the hip to modify the shape of the femoral head and correct acetabular abnormalities, though it carries some morbidity.

🔹 Periacetabular Osteotomy — This procedure is used to correct acetabular overcoverage and improve hip joint mechanics.

🔹 Mini-Open Anterior Approach — A less invasive approach that combines arthroscopy with a small incision to treat FAI, aiming to minimize complications.

🔹 Labral Refixation — Involves repairing the labrum to improve joint stability and function, often performed in conjunction with other FAI surgeries.

Clinical Outcomes

✅ Pain Relief — Studies report significant pain relief in 68-96% of patients undergoing FAI surgery, indicating positive short-term outcomes.

✅ Improved Function — Patients often experience improved hip function post-surgery, allowing for increased activity levels.

⏳ Recovery Time — Recovery times vary, but minimally invasive techniques like arthroscopy generally offer quicker rehabilitation.

📅 Long-term Data — Long-term follow-up is needed to assess the impact on osteoarthritis progression and overall hip joint survivorship.

👥 Patient Selection — Younger patients with less advanced osteoarthritis tend to have better outcomes post-surgery.

💡 "Reduced pain and improvement in hip function were reported in all studies."

Complications and Risks

⚠️ Major Complications — Occur in 0% to 18% of FAI surgeries, including risks like femoral neck fractures and nerve injuries.

Conversion to THA — Some patients may require conversion to total hip arthroplasty (THA), with rates reported between 0% and 26%.

🦠 Infection Risks — As with any surgery, there is a risk of infection, though it is generally low with proper surgical techniques.

🦴 Nonunion — In cases involving osteotomy, there is a risk of nonunion, particularly with trochanteric osteotomies.

🛡️ Minimizing Risks — Techniques like the mini-open anterior approach aim to reduce complications by avoiding dislocation and minimizing tissue disruption.

💡 "Major complications occurred in 0-18% of the procedures."