What question did this study set out to answer?

To evaluate the clinical outcomes and complications of different hip arthroscopy approaches for FAI syndrome.

January 23, 2026

Outcomes of Simultaneous Bilateral, Staged Bilateral, and Unilateral Hip Arthroscopy for Femoroacetabular Impingement Syndrome: A Systematic Review and Meta-analysis

NTNapatpong ThamrongskulsiriRush University Medical Center JMJacob MorganRush University Medical Center FCFelipe CasanovaRush University Medical Center

Puntos clave

To evaluate the clinical outcomes and complications of different hip arthroscopy approaches for FAI syndrome.
Conducted a systematic review and meta-analysis following PRISMA guidelines.
Searched databases including PubMed, Scopus, and Ovid MEDLINE.
Included studies comparing unilateral, simultaneous bilateral, and staged bilateral hip arthroscopy for FAI and reporting on various outcomes.
Included nine studies with 4040 hips showing significant improvements in pain and function for all approaches.
No significant differences in postoperative outcome scores among the three surgical approaches.
Meta-analyses revealed similar outcomes between staged and unilateral approaches.

Resumen

Background: Femoroacetabular impingement (FAI) is a common cause of hip pain, often treated with arthroscopy. The optimal approach among unilateral, staged bilateral, and simultaneous bilateral procedures remains unclear due to limited comparative data. Purpose: To compare clinical outcomes and complication rates among simultaneous bilateral, staged bilateral, and unilateral hip arthroscopy in patients with FAI syndrome. Study Design: Systematic review and Meta-analysis; Level of evidence, 3. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scopus, and Ovid MEDLINE databases were searched through April 2025. Eligible comparative studies included patients with FAI undergoing hip arthroscopy via unilateral, simultaneous bilateral, or staged bilateral approaches and reported outcomes such as patient-reported scores, complications, and revision or conversion to total hip arthroplasty (THA). Results: Nine studies with a total of 4040 hips were included. All surgical approaches showed significant improvements in pain and functional outcome scores. There were no statistically significant differences in postoperative visual analog scale score, Modified Harris Hip Score, Non-Arthritic Hip Score, International Hip Outcome Tool-12 score, rates of revision surgery, or conversion to THA among the 3 groups. Meta-analyses confirmed similar outcomes between staged and unilateral groups. Although 1 study reported a lower THA conversion rate in the simultaneous group, findings were inconsistent across the literature. Conclusion: Simultaneous bilateral, staged bilateral, and unilateral hip arthroscopy offer comparable short- to midterm outcomes and complication rates in FAI patients. Simultaneous bilateral arthroscopy may represent a safe and efficient option for appropriately selected patients. Surgical approaches should be individualized based on patient symptoms, goals, and risk profile. Registration: PROSPERO (CRD420251039957).

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