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What treatment options exist for patients with femoroacetabular impingement syndrome but without surgical indication?
  1. Nicola C Casartelli1,2,
  2. Mario Bizzini1,
  3. Joanne Kemp3,
  4. Florian D Naal4,
  5. Michael Leunig4,
  6. Nicola A Maffiuletti1
  1. 1Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
  2. 2Laboratory of Exercise and Health, ETH Zurich, Zurich, Switzerland
  3. 3La Trobe Sports Exercise Medicine Research Centre, La Trobe University, Bundoora, Victoria, Australia
  4. 4Department of Orthopaedic Surgery, Schulthess Clinic, Zurich, Switzerland
  1. Correspondence to Dr Nicola C Casartelli, Human Performance Lab, Schulthess Clinic Lengghalde 2, 8008 Zurich, Switzerland; nicola.casartelli{at}kws.ch

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Introduction

The most appropriate management for patients with femoroacetabular impingement (FAI) syndrome is a subject of much debate in sports medicine and orthopaedics. The recent Warwick Consensus Meeting proposed three main treatment approaches for patients with FAI syndrome: conservative care, physiotherapy-led rehabilitation or hip surgery.1 Most of the ongoing research focuses on investigating the effectiveness of hip surgery for FAI syndrome. Such studies—even if highly relevant—provide little information on non-surgical protocols for managing patients with a diagnosis of FAI syndrome who are still not candidates for hip surgery.2

Indications for hip surgery

Recently, the Warwick Consensus Meeting agreed on the criteria that should lead to a diagnosis of FAI syndrome.1 These criteria include the presence of symptoms, clinical signs and imaging findings. In contrast, indications for hip surgery in patients with a diagnosis of FAI syndrome are vague.3 Besides the level of hip joint damage, which might favour the surgical option for patients with early stages of chondral lesion and severe morphologies, the failure of non-surgical management is frequently considered the most important …

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