Zhang Wen, Chen Lei, Tong Peijian
The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, China.
J Orthop Surg Res. 2025 Jul 29;20(1):717. doi: 10.1186/s13018-025-06135-x.
BACKGROUND & AIMS: Femoroacetabular impingement (FAI) is a common hip disorder characterized by abnormal contact between the femoral head and acetabulum, leading to pain, restricted mobility, and potential osteoarthritis. Despite its clinical significance, the role of periarticular muscle alterations in FAI progression remains controversial. This study aimed to systematically evaluate hip muscle strength alterations and their clinical implications in FAI through meta-analysis.
This systematic review and meta-analysis adhered to PRISMA and AMSTAR guidelines, analyzing five cross-sectional studies (118 FAI patients, 89 controls) to compare hip muscle strength (flexion, extension, abduction/adduction) and functional outcomes (e.g., iHOT-33, HAGOS). Risk of bias was assessed using the Newcastle-Ottawa Scale.
FAI patients exhibited significantly reduced hip flexion (- 0.338 Nm/kg) and extension (- 0.379 Nm/kg) strength versus controls, with compensatory neuromuscular adaptations (e.g., preferential biceps femoris recruitment) and altered kinetic chains. Core muscle weakness and inconsistent fatigue patterns were also observed. Secondary outcomes lacked sufficient data for meta-analysis.
Muscle deficits in FAI are multifactorial, involving strength loss, maladaptive coordination, and kinetic chain disruptions. Targeted rehabilitation should integrate hip-centric and core stabilization exercises, but longitudinal studies are needed to validate therapeutic efficacy.
股骨髋臼撞击症（FAI）是一种常见的髋关节疾病，其特征是股骨头与髋臼之间存在异常接触，导致疼痛、活动受限以及潜在的骨关节炎。尽管其具有临床重要性，但关节周围肌肉改变在FAI进展中的作用仍存在争议。本研究旨在通过荟萃分析系统评估FAI患者髋关节肌肉力量的改变及其临床意义。
本系统评价和荟萃分析遵循PRISMA和AMSTAR指南，分析了五项横断面研究（118例FAI患者，89例对照），以比较髋关节肌肉力量（屈曲、伸展、外展/内收）和功能结局（如iHOT-33、HAGOS）。使用纽卡斯尔-渥太华量表评估偏倚风险。
与对照组相比，FAI患者的髋关节屈曲力量（-0.338 Nm/kg）和伸展力量（-0.379 Nm/kg）显著降低，伴有代偿性神经肌肉适应（如股二头肌优先募集）和动力链改变。还观察到核心肌肉无力和不一致的疲劳模式。次要结局缺乏足够的数据进行荟萃分析。
FAI患者的肌肉缺陷是多因素的，涉及力量丧失、适应性不良的协调以及动力链中断。有针对性的康复应结合以髋关节为中心和核心稳定练习，但需要纵向研究来验证治疗效果。
