Key result
Cam-type femoroacetabular impingement is a proven risk factor for hip osteoarthritis and arthroplasty, but there is currently no evidence that surgical correction alters this natural history.
Why the study?
This review evaluates the natural course of hip femoroacetabular impingement and examines whether surgical correction affects its progression to severe arthrosis and arthroplasty.
Does surgical correction of FAI prevent severe arthrosis and arthroplasty in patients with femoroacetabular impingement?
Does surgical correction of FAI prevent severe arthrosis and arthroplasty in patients with femoroacetabular impingement?
Despite cam-FAI being a known risk factor for hip osteoarthritis, current evidence does not support the assumption that prophylactic surgical correction alters the natural history or prevents the need for future hip arthroplasty.
Prophylactic cam-FAI surgery is not supported to prevent arthroplasty; leaves open whether correction modifies osteoarthritis progression.
This review article is devoted to the natural course of hip femoroacetabular impingement (FAI). The evolution of the understanding and views of surgeons on primary (idiopathic) arthrosis are considered. It is noted that nowadays, the primary arthrosis in fact almost always arises from anatomical variations. Among those are cam- and pincer-deformities, leading to impingement. In most of the major works, a reliable causal relationship of cam-FAI with arthrosis has been proven. Moreover, cam-FAI also carries the risk of impending arthroplasty. The association of pincer-FAI with arthrosis has been controversial. The course of FAI arthrosis, most likely, is not as aggressive as, for example, dysplastic arthrosis, and less often requires arthroplastics. Since cam-FAI is a reliable risk factor for arthrosis and arthroplasty, it could be assumed that timely surgical correction of FAI would stop or slow down arthrosis and avoid arthroplasty. However, at present, this assumption has not been proven, therefore, there is no reason to assert that surgery for FAI in any way affects its natural history in the form of severe arthrosis following by arthroplasty.
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А. П. Середа (2020) conducted a review in Femoroacetabular impingement (FAI) and coxarthrosis. Femoroacetabular impingement (cam and pincer types) vs. Normal hip anatomy was evaluated. Cam-type femoroacetabular impingement is a proven risk factor for hip osteoarthritis and arthroplasty, but there is currently no evidence that surgical correction alters this natural history.
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