Lived Experiences and Healthcare Perspectives of People With Femoroacetabular Impingement (FAI) Syndrome: A Systematic Review of Qualitative Studies

OBJECTIVE: To describe the lived experiences and healthcare perspectives of people with femoroacetabular impingement (FAI) syndrome to help guide patient-centered care. DESIGN: Pre-registered (CRD42024581726) systematic review of qualitative studies followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statements. LITERATURE SEARCH: Embase, CINAHL, MEDLINE, PsycINFO and Cochrane Library from inception to 24th June, 2024, using key subject and free-text terms, updated on 8th November 2024. STUDY SELECTION CRITERIA: We included English-language qualitative and mixed methods studies that explored the experiences, beliefs, attitudes, perspectives, and/or needs of individuals aged ≥12 years with FAI syndrome. Studies with ≥5 participants were included; there were no publication date restrictions. We used the Critical Appraisal Skills Program (CASP) qualitative and mixed methods checklist to assess methodological quality. DATA SYNTHESIS: We conducted a hybrid framework and thematic synthesis using the Common-Sense Model of Self-Regulation. Certainty of findings was assessed using the GRADE-Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) framework. RESULTS: Eight studies (4 qualitative, 4 mixed methods) with 409 participants were included. Four key themes were identified: (1) Physical and psychosocial effects of FAI syndrome and its care; (2) Preference for surgery based on pathoanatomical and biomechanical beliefs; (3) Unmet needs and expectations; (4) Varied perceptions of physiotherapy. CONCLUSION: This review highlighted the physical and psychosocial impacts of FAI syndrome. Patient education and support may be valuable to set realistic treatment expectations and improve surgical and non-surgical treatment outcomes.