Abstract
PurposeThe purpose of this study was to assess the additional effect of anterior inferior iliac spine (AIIS) decompression on knee extensor and hip flexor strength and compare functional outcomes after arthroscopic FAI correction with and without AIIS decompression.MethodsSixty patients who underwent arthroscopic FAI correction surgery were divided into two groups matched for AIIS morphology: 31 patients who underwent arthroscopic FAI surgery only (without AIIS decompression) (FAI group) (AIIS Type I; n = 5, Type II; n = 26, Type III; n = 0) and 29 patients who underwent arthroscopic FAI surgery with AIIS decompression (AIIS group) (AIIS Type I; n = 5, Type II; n = 24, Type III; n = 0). Knee extensor and hip flexor strength were evaluated preoperatively and at 6 months after surgery. Patient-reported outcome (PRO) scores using the modified Harris hip score (MHHS), the nonarthritic hip score (NAHS) and iHOT-12 were obtained preoperatively and at 6 months after surgery.ResultsIn the AIIS group, there was no significant difference between knee extensor strength pre- and postoperatively (n.s.). In the AIIS group, hip flexor strength was significantly improved postoperatively compared to preoperative measures (p < 0.05). In the FAI group, there were no significant improvements regarding muscle strength (n.s.). While there were no significant differences of preoperative and postoperative MHHS and NAHS between both groups (MHHS; n.s., NAHS; n.s.), the mean postoperative iHOT-12 in the FAI group was inferior to that in the AIIS group. (p < 0.01). The revision surgery rate for the AIIS group was significantly lower compared with that in the FAI group (p < 0.05).ConclusionAnterior inferior iliac spine decompression, as a part of an arthroscopic FAI corrective procedure, had a lower revision surgery rate and did not compromise knee extensor and hip flexor strength, and it improved clinical outcomes comparable to FAI correction without AIIS decompression. AIIS decompression for FAI correction improved postoperative PRO scores without altering the muscle strength of hip flexor and knee extensor.Level of evidenceIII.
Highlights
Femoroacetabular impingement (FAI) is one of the most common sources of hip pain and discomfort [9]
This study mainly focuses on investigating whether anterior inferior iliac spine (AIIS) decompression as a part of FAI correction surgery affect hip flexor and knee extensor muscle strength or not
There was no significant difference for preoperative knee extensor strength between the involved side and noninvolved side for the AIIS group (n.s.) (Table 2)
Summary
Femoroacetabular impingement (FAI) is one of the most common sources of hip pain and discomfort [9]. FAI is the most frequent indication for arthroscopic hip surgery. It has been better defined that residual AIIS impingement is one of the most common predictors of revision and poor clinical outcomes following arthroscopic FAI correction [19, 29]. AIIS decompression can affect postoperative results following arthroscopic FAI surgery [19, 29, 30]. The current authors perform an additional AIIS decompression as a part of an arthroscopic FAI corrective surgery if AIIS impingement is suspected based on examination, imaging, and intraoperative findings
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