Hip surgery for femoroacetabular impingement syndrome (FAI)

Femoroacetabular impingement (FAI) results from abnormal morphology of the acetabulum and femoral head/neck resulting in abnormal contact between the proximal femur and acetabulum during the end range of hip motion, particularly flexion and internal rotation. There are two types of FAI: cam impingement (non-spherical femoral head or abnormality at the head-neck junction) and pincer impingement (deep or retroverted acetabulum resulting in over coverage of the femoral head).

Femoroacetabular impingement (FAI) syndrome was first reviewed by the HTA program in 2011.

In 2014, a review of FAI medical literature was conducted to determine if newly available published evidence could change the original coverage determination. The technology was not selected for rereview.
In 2018, a second update literature review was conducted. The technology was not selected for rereview.
In 2019, the HCA director selected FAI for rereview based on newly available published evidence that could change the original coverage determination.
A rereview of femoroacetabular impingement syndrome was completed in 2019.

Status: Decision completed

View findings and decision

Why is FAI being reviewed?

Proponents believe that surgical correction of the impinging deformities will alleviate the symptoms and retard the progression of OA degeneration. However, significant questions remain about the safety, efficacy and effectiveness, and cost effectiveness of hip surgery for FAI.

Primary criteria ranking

Safety = Medium
Efficacy = High
Cost = High

Documentation

Type	Materials
Update literature (2023)	Evidence update literature
Assessment (2019)	Draft key questions: comment and response Final key questions Draft evidence report: comment and response Final evidence report Final evidence report: appendices Final findings and decision
Update literature (2018)	Evidence update literature
Update literature (2014)	Evidence update literature
Assessment (2011)	Final key questions Public comments and responses Final evidence report Final findings and decision

Assessment timeline (2019)

Draft key questions published: May 28, 2019
- Public comment period: May 28 to June 11, 2019
Final key questions published: June 19, 2019
Draft report published: September 5, 2019
- Public comment period: September 5 to October 4, 2019
Final report published: October 23, 2019
HTCC public meeting: November 22, 2019