Arthroscopy versus mini-open surgery for femoroacetabular impingement : A systematic review of clinical outcomes.
Filippo Migliorini, Nicola Maffulli, Manuel Giovanni Mazzoleni et al.
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In 30 seconds
This systematic review compared arthroscopic with mini-open surgery for symptomatic femoroacetabular impingement (FAI), including 233 clinical studies and 54,272 patients. Mean follow-up was 33.9 ± 22.7 months. Arthroscopy was associated with statistically higher VAS and modified Harris Hip Score values, but the differences were judged to have minimal clinical relevance. Reoperation risk was higher with arthroscopy (OR 8.9; P < 0.01), while progression to total hip arthroplasty did not differ significantly (OR: 0.9; P = 0.4). Overall clinical outcomes were similar, with lower reoperation risk associated with mini-open surgery.
Key findings
- Arthroscopy had higher VAS scores (MD 1.2/10; P = 0.02) and mHHS values (MD 3.3/100; P < 0.01), with minimal clinical relevance.
- Reoperation risk was higher in the arthroscopy group (OR 8.9; P < 0.01).
- Progression to total hip arthroplasty did not differ significantly between approaches (OR: 0.9; P = 0.4).
Why it matters
The review suggests that both approaches yield broadly similar clinical outcomes over approximately 34 months, while reoperation risk may differ. This distinction can inform discussion of surgical options and expected outcomes, but the small clinical relevance of score differences and the absence of a significant difference in progression to arthroplasty are important context.
What to keep in mind
Mean follow-up was approximately 34 months, and the authors call for longer-term follow-up and standardized outcome measures.