Surgery or PT for Hip FAI?

Catherine Logan

October 29th, 2019

Research Updates…
Arthroscopic Surgery or Physical Therapy for Patients with Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial with 2-Year Follow-up

SourceAJSM, first published February 14, 2018
Clinical Question: To determine the comparative effectiveness of surgery and physical therapy for femoroacetabular impingement (FAI) syndrome.
Bottom Line: There was no significant difference between the groups (PT vs surgery) at 2 years.
Points to consider: Limitations included a high rate of crossover between RCT groups. PT was 12-sessions within 3 weeks. RCT at a single hospital, with a single surgeon. The population was military patients only.
Takeaway: Statistically significant improvements were seen in BOTH groups on the Hip Outcome Score (HOS) and International Outcome Tool (iHOT-33) at 2-years.

Further notes…This trial is the first to compare surgical and nonsurgical interventions for FAI out at 2 years. With no difference in outcomes, the downstream fiscal implications of treatment choices merit further consideration. Complication rates are low and comparable. Despite improvements over time, no meaningful change was perceived by most patients (in either group) – therefore, it is difficult to make definitive conclusions. These findings do indicate that larger, multi-center trials of appropriate power are needed.