Mahmoud Samer S S, Takla Amir, Meyer Denny, Griffin Damian, O'Donnell John
Hip Arthroscopy Australia, 21 Erin Street, Richmond, VIC 3121, Australia.
Department of Health Professions, Faculty of Health, Arts and Design, Sports & Musculoskeletal Physiotherapist, Australian Sports Physiotherapy, Swinburne University of Technology, Hip Arthroscopy Australia, 21 Erin Street, Richmond, VIC 3121, Australia.
J Hip Preserv Surg. 2022 Mar 10;9(2):107-118. doi: 10.1093/jhps/hnac012. eCollection 2022 Jul.
Targeted physiotherapy programs (TPP), and surgery, using either open surgical hip dislocation or hip arthroscopy (HA), are the treatment modalities available for femoroacetabular impingement syndrome (FAIS). Randomized controlled trials have recently been performed to compare these treatment options. This review was performed to provide a focused synthesis of the available evidence regarding the relative value of treatment options. A systematic search was performed of Medline, Embase, Cochrane Library and ClinicalTrials.gov databases. Inclusion criteria were randomized controlled trials comparing treatment methods. The Cochrane Risk of Bias assessment tool (RoB2) was used to assess the selected studies. A meta-analysis was performed between homogenous studies. Four trials were identified including 749 patients (392 males). The mean ages of the cohorts ranged between 30.1 and 36.2 years old. Three hundred thirty-five patients underwent HA by 46 surgeons among all trials. Fifty-two patients crossed over from the TPP to the HA group. One of the trials was found to have a high risk of bias, while the other three were between low risk and some concerns. The iHOT-33 was the most commonly used patient-reported outcome measure followed by the HOS ADL and EQ-5D-5L. Others scores were also identified. Scores from two trials could be pooled together for meta-analysis. Apart from SF-12 and GRC, all other scores have shown significantly better outcomes with HA in comparison to TPP at 8- and 12-months follow-up points. HA offers better patient-reported outcomes than TPP for management of FAIS at 8- and 12-months follow-up.
针对股骨髋臼撞击综合征（FAIS），有针对性的物理治疗方案（TPP）以及采用开放式手术性髋关节脱位或髋关节镜检查（HA）的手术是可用的治疗方式。最近已经进行了随机对照试验来比较这些治疗选择。本综述旨在对有关治疗选择相对价值的现有证据进行重点综合分析。对Medline、Embase、Cochrane图书馆和ClinicalTrials.gov数据库进行了系统检索。纳入标准为比较治疗方法的随机对照试验。使用Cochrane偏倚风险评估工具（RoB2）来评估所选研究。对同类研究进行了荟萃分析。共确定了4项试验，包括749名患者（392名男性）。各队列的平均年龄在30.1岁至36.2岁之间。在所有试验中，46名外科医生为335名患者进行了髋关节镜检查。52名患者从TPP组转入HA组。发现其中1项试验存在高偏倚风险，而其他3项试验的偏倚风险处于低风险和有些担忧之间。iHOT-33是最常用的患者报告结局指标，其次是HOS ADL和EQ-5D-5L。还确定了其他评分。两项试验的评分可合并用于荟萃分析。除了SF-12和GRC外，在8个月和12个月的随访点，与TPP相比，HA在所有其他评分方面均显示出显著更好的结局。在8个月和12个月的随访中，对于FAIS的管理，HA比TPP能提供更好的患者报告结局。
