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
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) | |
| Assessment (2019) | |
| Update literature (2018) | |
| Update literature (2014) | |
| Assessment (2011) |
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