Minimal Hip Flexion Increase During Gait After Femoroacetabular Impingement Surgery: A Systematic Review and Meta-analysis of Pre- and Postoperative 3-Dimensional Motion Analysis.

Abstract

To evaluate the impact of surgical treatment on gait biomechanics in patients with femoroacetabular impingement syndrome (FAIS). A comprehensive search of 6 databases (from inception to 2024) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (CRD4202347397). Studies using 3-dimensional motion analysis to examine gait kinematics and/or kinetics in patients with FAIS before and after hip surgery were included. Studies analyzing data from patients with FAIS who had undergone surgery but lacked baseline presurgical data from the same patients or compared patients to controls without evaluating both pre- and postsurgical biomechanics were excluded. Qualitative and quantitative analyses were performed. Thirteen studies were reviewed qualitatively, and 12 were included in the meta-analysis, encompassing 279 presurgical and 268 postsurgical patients. Motion analysis was conducted 6 to 24.2 months postoperatively. Meta-analysis showed a statistically significant improvement of 1.3° in peak hip flexion angle during the gait cycle, although this may have limited clinical relevance. Other kinematic and kinetic parameters did not show significant differences. The quality of the studies was moderate or high. This study showed a statistically significant increase in peak hip flexion and abduction angle throughout the gait cycle after surgery, although these changes were clinically negligible. The lack of significant changes in other kinematic and kinetic parameters indicates that factors beyond bone deformities may influence outcomes. These findings highlight the multifactorial nature of FAIS and suggest gait analysis alone may not fully capture postoperative biomechanical adaptations. Level IV, systematic review of Level I to IV studies.