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Hip surgery for femoroacetabular impingement syndrome (FAI)
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 re-review.
- In 2018, a second update literature review was conducted. The technology was not selected for re-review.
- In 2019, the HCA director selected FAI for re-review based on newly available published evidence that could change the original coverage determination.
- A re-review of femoroacetabular impingement syndrome was completed in 2019.
Femoroacetabular impingement (FAI) syndrome is a recently recognized diagnosis in primarily younger individuals where relatively minor abnormalities in the joint (orientation or morphology) are thought to cause friction/impingement and pain. It is theorized that FAI starts the breakdown of cartilage, leading to osteoarthritis (OA). There are two types of FAI: cam impingement (most common in young athletic males) and pincer impingement (most common in middle-aged women).
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
- Draft key questions: comment and response (6/25/19)
- Final key questions (6/19/19)
- Draft evidence report: peer review, comment and response (10/23/19)
- Final evidence report (10/22/19)
- Final evidence report: appendices (10/22/19) (Updated: 10/31/19)
- Final findings and decision (1/17/2020)
Update literature (2018)
Update literature (2014)
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