Abstract

LANTARON-CAEIRO, Eva M.; LOPEZ-LLORENTE, Álvaro; SANTAMARIA-GOMEZ, Gema  and  FERNANDEZ-LAZARO, Diego. Comparative efficacy of surgical and conservative treatment for femoro-acetabular impingement. A Systematic Review. Invest. clín [online]. 2025, vol.66, n.4, pp.454-466.  Epub Dec 16, 2025. ISSN 0535-5133.  https://doi.org/10.54817/ic.v66n4a08.

Femoro-acetabular impingement (FAI) is a clinical syndrome characterized by a space conflict between the acetabulum and the femoral head, which causes premature degeneration and joint pain. For this, an adequate therapeutic approach is necessary. However, there is no consensus on whether the primary treatment should be surgical or conservative. Therefore, the present study aimed to review the available scientific evidence on the effectiveness of physiotherapy compared to arthroscopy in patients with FAI. Following the “Preferred Reporting Items for Systematic Review and Meta-Analyses” (PRISMA) guidelines, we systematically reviewed randomized clinical trials published over the last 15 years comparing conservative treatment with the arthroscopic approach in FAI, analyzing joint function and patient quality of life. The search was performed in the Medline, “Physiotherapy Evidence Database” PEDro and Cochrane databases. In addition, the methodological quality was evaluated using the PEDro and the “Cuestionario Critical Appraisal Skills Programme Español” (CASPe) scales, and the risk of bias was assessed using the Cochrane tool. Six trials met the established selection criteria, including 744 patients aged 30 to 50 years. Significant improvements (p<0.05) in quality of life were observed with hip arthroscopy compared with conservative treatment. There is no consensus on joint function. In conclusion, the FAI approach via arthroscopic treatment could significantly improve patients’ quality of life compared with physiotherapy. These results would position surgical treatment as the best first-line treatment option for FAI. However, further studies with larger sample sizes and longer follow-ups are needed to evaluate the definitive approach to FAI.

Keywords : Femoroacetabular Impingement; Physical Therapy Modalities; Arthroscopy; Quality of Life; Range of Motion Articular.

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