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SHORT-TERM OUTCOMES OF CONSERVATIVE TREATMENT FOR FEMOROACETABULAR IMPINGEMENT: A SYSTEMATIC REVIEW AND
Emma Mallets1, Ann Turner1, Jeremy Durbin1
1Walsh University; North Canton, OH, USA.
International Journal of Sports Physical Therapy
|August 24, 2019
Summary
Conservative physical therapy significantly improves pain and function in patients with femoroacetabular impingement (FAI). Intra-articular injections show smaller benefits, suggesting physical therapy is a more promising treatment for FAI.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Rehabilitation Science
Background:
- Femoroacetabular impingement (FAI) is increasingly prevalent, causing significant pain, functional limitations, and reduced quality of life.
- Conservative management, including physical therapy and intra-articular injections, is typically pursued before surgical intervention.
- Optimizing conservative care strategies is crucial for improving patient outcomes in FAI.
Purpose of the Study:
- To systematically review and meta-analyze the short-term efficacy of conservative physical therapy and intra-articular injections for managing pain and physical function in FAI patients.
- To compare the effectiveness of physical therapy versus intra-articular injections as conservative treatments for FAI.
Main Methods:
- A systematic review and meta-analysis were conducted following PRISMA guidelines.
- Literature search performed in May 2018 across major databases (PubMed, CINAHL, Proquest, Scopus).
- Included studies focused on FAI patients receiving conservative rehabilitation and reporting pain or function outcomes; excluded studies lacked skilled interaction or complete protocols.
Main Results:
- Seven studies were included, evaluating physical therapy or intra-articular injections for FAI.
- Conservative interventions effectively reduced pain and improved function in the short term.
- Physical therapy demonstrated moderate to large effect sizes for pain (SMD 0.91) and function (SMD 0.80) improvements.
- Intra-articular injections showed small effect sizes for pain (SMD 0.29) and small to moderate for function (SMD 0.49).
Conclusions:
- Physical therapy yields positive outcomes for self-reported pain and function in FAI, potentially offering greater promise than injections alone.
- Effective conservative treatments include patient education, activity modification, manual therapy, and strengthening exercises.
- Future research should address the limited number of high-quality studies in this area.
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