Surgical indications for treatment for femoroacetabular impingement with surgical hip dislocation.
OBJECTIVE
There is a lack of detailed information about the indications of surgical treatment for femoroacetabular impingement (FAI), particularly using open surgical dislocation. The purpose of this review was to systematically review the reported indications for surgical dislocation of the hip for FAI.


METHODS
Two databases (MEDLINE and EMBASE) were screened for clinical studies involving the treatment for FAI with surgical hip dislocation. We conducted a full-text review and the references for each included paper were hand-searched for other eligible studies. Papers published until September 2011 were included in this review. Two individuals reviewed all identified studies independently, and any disagreement was resolved through consensus.


RESULTS
Fifteen studies met the eligibility criteria, which included a total of 822 patients. We identified a lack of consensus for clinical and radiographic indications for surgical hip dislocation to treat FAI. The most common clinical indications reported were clinical symptoms such as hip pain in 10 papers (67 %), a positive impingement sign in 9 papers (60 %), painful/reduced range of motion in 9 papers (60 %), activity-related groin pain in 4 papers (27 %), and non-responsive to non-operative treatment in 4 papers (27 %). The most commonly reported radiographic indicators for surgical hip dislocation were a variety of impingement findings from radiographs in all 15 included papers (100 %), a combination of radiographs and MRA in 5 papers (33 %) or radiographs and MRI in 3 papers (20 %).


CONCLUSIONS
These results showed that that there was an inconsistency between the clinical and radiographic indications for surgical hip dislocation as a treatment for femoroacetabular impingement. This review suggests that there is a need for the development of standardized clinical and radiological criteria that serve as guidelines for surgical treatment for FAI.


METHODS
Systematic review, Level IV.
Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main Street West, Hamilton, ON, Canada. femiayeni@gmail.com
Olufemi R
OR
Ayeni
Douglas
D
Naudie
Sarah
S
Crouch
Anthony
A
Adili
Bharadwaj
B
Pindiprolu
Teresa
T
Chien
Paul E
PE
Beaulé
Mohit
M
Bhandari
D057925:Femoracetabular Impingement / Q000000981:diagnostic imaging / Q000601:surgery*; D006617:Hip Dislocation; D006801:Humans; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular