Clinical outcomes of arthroscopic surgical intervention in femoroacetabular impingement amongst the Asian population: A meta-analysis.
Review
Overview
abstract
IMPORTANCE: In Asian populations, increased prevalence of hip dysplasia as well as activities of daily living which require increased hip range of motion, such as squatting, may impact outcomes of arthroscopic surgery for femoroacetabular impingement (FAI) when compared to their Western counterparts. Existing literature lacks a comprehensive review and synthesis of knowledge focusing on outcomes of arthroscopic intervention for FAI in the Asian population. OBJECTIVE: To conduct the first systematic review and meta-analysis that examines outcomes of arthroscopic intervention in Asian patients with FAI. EVIDENCE REVIEW: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Cochrane Library databases were reviewed. Case series or cohort studies assessing outcomes of arthroscopic intervention in FAI were included. Pooled analysis of modified Harris Hip Score (mHHS), Visual Analogue Scale (VAS), and adverse events were conducted. Rate of revision surgery and conversion to total hip arthroplasty (THA) were analysed as well. FINDINGS: Six studies (5 case series, 1 cohort study) of high methodological quality involving 498 patients were included. Age of patients ranged from 20s to 70s, with a balanced gender ratio. Pooled patient-reported outcomes improved significantly postoperatively. VAS at the last follow-up mark improved by -4.28 (95 % CI, -4.49 to -4.08, P < 0.00001), and VAS at the 12-month post-operation mark improved by -4.11 (95 % CI, -4.34 to -3.88, P < 0.00001). The mHHS at the last follow-up mark improved by 23.37 (95 % CI, 20.29-26.45, P < 0.00001). Revision surgery rate was low at 2.8 % and conversion to THA rate was 0.3 %. CONCLUSIONS AND RELEVANCE: Arthroscopic intervention in FAI provides favorable outcomes in the Asian population that is comparable with outcomes seen in the Western population. LEVEL OF EVIDENCE: Meta-analysis; Level of evidence, IV.
