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- Talk
- 13/09/2021
- UK
Outcomes following Surgical Management of Femoroacetabular Impingement: A Systematic Review and Meta-analysis of Different Surgical Techniques
Description
In this presentation, Sunil Kumar discusses his research on the outcomes of surgical management for Femoroacetabular Impingement (FAI). He defines FAI as a condition characterized by abnormal contact between the femoral head-neck junction and the acetabulum, highlighting its various forms including CAM and PINCER types. The goal of surgical interventions is to preserve hip function by correcting structural abnormalities and addressing associated cartilage and labrum damage. Sunil provides insight into the evolution of surgical techniques including open surgical dislocation and advancements in arthroscopic surgery.
His systematic review, conducted under PRISMA guidelines, analyzed data from 48 articles encompassing over 4,000 patients and examined outcomes spanning at least 12 months post-surgery using the MINORS score for risk assessment. Key findings indicate that the anterior mini open approach (AMO) achieved superior patient-reported outcomes (PROMs) compared to arthroscopy and surgical dislocation. However, it also had a higher complication rate, particularly due to potential nerve injuries. He notes that while there was no significant difference in alpha angle correction across the surgical methods, the AMO appeared to result in greater correction overall.
Sunil concludes that although all three surgical methods yielded significant improvements in PROMs and deformity correction, the AMO approach's benefits come with increased risks. A follow-up Q&A session with Chris Bretherton touches on the clinical significance of these findings, particularly challenging the appropriateness of using the minimum clinically important difference (MCID) in measuring patient outcomes, suggesting alternative evaluation metrics like the Patient Acceptable Symptom State (PASS). The presentation emphasizes the need for further exploration into what constitutes a meaningful difference in patient recovery.