Incidence of Femoroacetabular Impingement and Surgical Management Trends Over Time

Abstract

Background: Femoroacetabular impingement (FAI) is a well-known cause of hip pain in adolescents and young adults. However, the incidence in the general population has not been clearly defined. Purpose: To (1) define the population-based incidence of diagnosis of FAI in patients with hip pain, (2) report the trends in diagnosis of FAI over time, and (3) determine the changes in the rate and type of surgical management over time. Study Design: Cohort study; Level of evidence, 3. Methods: A geographic database was used to identify patients who were 14 to 50 years old with hip pain between the years 2000 and 2016. Chart and radiographic review was performed to determine which patients had FAI. To be included, patients had to have a triad of clinical symptoms, physical examination signs, and imaging findings consistent with FAI. Medical records were reviewed to obtain demographic information, clinical history, physical examination findings, imaging details, and treatment details. Statistical analysis determined the overall age- and sex-adjusted annual incidence of FAI diagnosis and trends over time. Results: There were 1893 patients evaluated with hip pain, and 716 (38%; 813 hips) had diagnosed FAI. The mean ± SD age was 27.2 ± 8.4 years, and 67% were female. The incidence of FAI diagnosis was 54.4 per 100,000 person-years. Female patients had a higher incidence than male patients (73.2 vs 36.1 per 100,000 person-years; P < .01). Incidence of FAI diagnosis were higher from 2010 to 2016 (72.6 per 100,000 person-years; P < .01) as compared with 2005 to 2009 (45.3) and 2000 to 2004 (40.3). Hip arthroscopy, surgical hip dislocation, and periacetabular osteotomy utilization increased from the 2000-2004 to 2010-2016 periods, respectively: 1 (1%) to 160 (20%; P = .04), 2 (1%) to 37 (5%; P = .01), and 1 (1%) to 22 (3%; P = .58). Conclusion: The overall incidence of FAI diagnosis was 54.4 per 100,000 person-years, and it consistently increased between 2000 and 2016. Female patients had a higher incidence than male patients. The utilization of joint preservation operations, including hip arthroscopy, surgical hip dislocation, and anteverting periacetabular osteotomy, increased over time.

Machine Learning Model Identifies Increased Operative Time and Greater BMI as Predictors for Overnight Admission After Outpatient Hip Arthroscopy

“…Orthopedic surgeons have witnessed a paradigm shift in the management of FAI and hip labral pathology, with a reported 365% increase in utilization of hip arthroscopy since 2004. 1,5,20 As the prevalence of hip arthroscopy procedures continues to increase, it is important to identify patient characteristics and risk factors related to perioperative and postoperative complications. OVERNIGHT ADMISSION AFTER HIP ARTHROSCOPY e5…”

Editorial Commentary: Subgluteal Hip Arthroscopy for Sciatic Nerve Entrapment, Ischiofemoral Impingement, or Proximal Hamstring Tears: Beyond the Comfort Zone

“…The incidence of FAIS diagnosis was reported to be 54.4 per 100,000 person-years and has consistently increased between 2000 and 2016. 1 Yet, this is only one of the many indications that can be addressed with hip arthroscopy/endoscopy. Sciatic nerve entrapment (SNE), ischiofemoral impingement (IFI), and tears of the proximal origin of the hamstring are amid the subgluteal space pathologies.…”

Benefits of a Specific and Supervised Rehabilitation Program in Femoroacetabular Impingement Patients Undergoing Hip Arthroscopy: A Randomized Control Trial

“…Femoroacetabular impingement syndrome (FAIS) is a well-known cause of hip pain in adolescents and young adults, with an overall incidence of FAIS diagnosis of 54.4 per 100,000 person-years [ 1 ]. There are two types; one of them is due to morphological abnormalities of the proximal femur, typically located on the anterolateral portion of the femoral head-neck junction, which is referred to as cam impingement, while acetabulum-related impingement is referred to as pincer-type [ 2 , 3 ] After forced flexion with an internal rotation, it can produce an abnormal contact between the femoral head-neck junction and the anterosuperior rim of the acetabulum, which over time can alter the function of joint sealing performed by the labrum.…”