Does femoroacetabular impingement syndrome affect range of motion? A systematic review with meta-analysis

Albertoni, Davide Bruno; Gianola, Silvia; Bargeri, Silvia; Hoxhaj, Ilda; Munari, Alice; Maffulli, Nicola; Castellini, Greta

Abstract

AbstractBackgroundIt is unclear whether femoroacetabular impingement syndrome (FAIS) affect hip range of motion (ROM).Sources of dataWe performed a systematic review with meta-analysis searching six electronic databases from inception to March 21, 2022. We included studies assessing hip ROM in FAIS, FAI morphology without symptoms (FAIm), and healthy controls. Mean differences between groups were measured in ROM degrees with 95% confidence interval (CI).Areas of agreementA total of 17 studies (1702 hips) were included. Comparison of FAIS patients versus healthy controls showed that hip ROM was clinically and statistically reduced in FAIS for internal rotation (90° hip flexion, −8.01°, 95% CI: –11.21, −4.90; 0° hip flexion −6.38°, 95% CI: –9.79, −2.97); adduction (90° hip flexion, −4.74°, 95% CI: –8.13, −1.34); flexion (−5.41°, 95% CI: –7.05, −3.49), abduction (0° hip flexion, −5.76°, 95% CI: –8.38, −3.23), and external rotation (90° hip flexion, −3.5°, 95% CI: –5.32, −1.67) ranging from low to high certainty of evidence. Comparison of FAIm versus healthy controls showed no statistically significant differences in any direction of movement, albeit with uncertainty of evidence.Areas of controversyThe certainty of evidence was unclear, particularly for asymptomatic FAIm.Growing pointsHip ROM may be reduced in all directions except extension in FAIS compared to controls. Hip ROM may not be restricted in asymptomatic FAIm.Areas timely for developing researchFurther studies are needed to resolve the uncertainty of evidence about ROM restrictions in asymptomatic FAIm compared to healthy controls.

Citation

Albertoni, D. B., Gianola, S., Bargeri, S., Hoxhaj, I., Munari, A., Maffulli, N., & Castellini, G. (2023). Does femoroacetabular impingement syndrome affect range of motion? A systematic review with meta-analysis. British Medical Bulletin, 145(1), 45-59. https://doi.org/10.1093/bmb/ldac027

• Journal Article Type: Article
• Acceptance Date: Oct 3, 2022
• Online Publication Date: Nov 11, 2022
• Publication Date: Apr 5, 2023
• Deposit Date: Jan 11, 2024
• Journal: British Medical Bulletin
• Print ISSN: 0007-1420
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 145
• Issue: 1
• Pages: 45-59
• DOI: https://doi.org/10.1093/bmb/ldac027
• Keywords: General Medicine