Nonsurgical Versus Surgical Management of Femoroacetabular Impingement

What Does the Current Best Evidence Tell Us

Ian Gao, MD; Marc R. Safran, MD


J Am Acad Orthop Surg. 2021;29(10):e471-e478. 

In This Article


FAI morphology is common and can lead to hip labral tears, chondral damage, and subsequent OA. Many patients with symptomatic FAI can be treated successfully with nonsurgical management as first-line treatment. However, when nonsurgical management fails, surgery should be considered. There is rapidly increasing evidence for the efficacy of hip arthroscopy for the treatment of symptomatic FAI, and hip arthroscopy has shown superior outcomes compared with nonsurgical management and PT in most recent randomized controlled trials. Future large prospective studies are needed to evaluate the effect on the outcomes when there is a delay in surgical management in symptomatic individuals, assess whether FAI surgery prevents or delays OA, and determine the role of other advanced surgical techniques.