|Beitragstitel||Pain, activities of daily living and sport function at different time points after hip arthroscopy in patients with femoroacetabular impingement: a systematic review with meta-analysis|
Introduction: Hip arthroscopy seems to reduce hip pain and improve function of patients with femoroacetabular impingement (FAI) mostly based on low level of evidence case series. Hip arthroscopy outcomes have been mainly assessed using composite scores at a single time point after surgery, which do not enable the evaluation of changes in specific domains over time. The aim of this systematic review was to investigate hip pain, activity of daily living (ADL) function, sport function, quality of life and satisfaction reported by patients with FAI at different time points after hip arthroscopy.
Methods: The databases EMBASE, MEDLINE, SportsDiscus, CINAHL, Cochrane Library and PEDro were searched until 20 September 2015. Studies that evaluated pain, ADL function, sport function, and quality of life by means of outcomes subscores before and after hip arthroscopy and postoperative satisfaction in patients with symptomatic FAI were included.
Results: A total of 26 studies (22 case series, 3 cohort studies, 1 randomised controlled trial) were included in the systematic review and 19 in the meta-analysis. Clinically relevant pain and ADL function improvements were first reported between 3 and 6 months, and sport function improvements between 6 months and 1 year after surgery. It is not clear when quality of life improvements were first achieved. On average, residual mild pain and ADL and sport function scores lower than their healthy counterparts were reported by patients following surgery. Postoperative patient satisfaction ranged from 68% to 100%.
Conclusion: On average, patients reported earlier pain and ADL function improvements, and slower sport function improvements after hip arthroscopy for FAI. However, average scores from patients indicate residual mild hip pain and/or hip function during ADL and sport lower than their healthy counterparts after surgery. Owing to the current low level of evidence, future randomised controlled trials and cohort studies should investigate the effectiveness of hip arthroscopy in patients with FAI.