What Are the Indications for Surgical Intervention for Patients Who Have Femoro-acetabular Impingement of the Hip?
Authors: Parsa A, Domb BG, Parvizi J, Tuncai I, Kobayashi N, Charr O, Ariamanesh A
DOI: 10.1016/j.arth.2024.10.115
Journal: Journal of Arthroplasty, 2025
Objective
To define standardized indications for surgical management of femoroacetabular impingement (FAI), based on international consensus and clinical practice guidelines.
Methodology
A consensus-based review of global orthopedic practices, incorporating expert opinion, imaging criteria, and clinical examination to define surgical indications for FAI.
Key Findings
- Surgery is indicated when patients with confirmed FAI remain symptomatic despite a trial of nonoperative management.
- Clinical decision-making should be guided by a combination of physical exam findings, radiographic features (e.g., cam/pincer morphology), and functional impairment.
- The study provides a unified international framework for surgical consideration.
Conclusion
There is strong agreement that surgical treatment for FAI is appropriate in symptomatic patients unresponsive to conservative care. Imaging and physical findings should support diagnosis before proceeding to surgery.
What Does This Mean for Providers?
This consensus provides clear guidance for orthopedic surgeons treating FAI. Providers should ensure that patients meet specific clinical and radiographic criteria before recommending surgical intervention. Emphasizing appropriate patient selection and timing of surgery is essential for optimizing outcomes and avoiding overtreatment. This framework also aids in standardizing decision-making across practices and institutions.