Conflits fémoro-acétabulaires, options de traitement et rééducation: une revue narrative (partie 2)

Introduction: The femoroacetabular impingement syndrome (FAIS) is responsible for over 50% of cases of secondary hip osteoarthritis. Appropriate management is therefore essential. In that sense, two main therapeutic approaches are conceivable: the surgical approach aimed at correcting the biomechanical conflict, and the conservative approach. The purpose of this article is to summarise the evidence available in the literature on the description and comparison of the various treatment options, both surgical and conservative, as well as the main lines of management of FAIS. Material and methods: Searches were conducted in the “Pubmed” database. The terms “femoroacetabular impingement AND treatment” were applied in the search engine in order to target the problematic studied. Only systematic reviews and meta-analyses were retained, as these correspond to the highest level of scientific value. Results: The research identified 181 systematic reviews and meta-analyses related to the treatment of FAIS. Nine of them were selected to meet our objective. In terms of surgical approach, the techniques developed to treat FAIS are numerous and have evolved rapidly. Arthroscopic surgery has become widely prevalent and is proving to be the interventional option of choice. In contrast, the conservative approach (strengthening, mobility, pain relief, education) has been slower to develop, although it is now offering very encouraging results. Currently, arthroscopic surgery appears to offer better results than the conservative approach when comparing the scores obtained from the iHOT-33 and EQ-5D-5L index questionnaires. Conclusion: Both treatment approaches (conservative and surgical) show interesting improvements in patients suffering from FAIS. In the future, it would make sense to combine them rather than confront them, as they address different treatment axes that are in no way in opposition.