Combined Hip Arthroscopy and Limited Open Osteochondroplasty for Anterior Femoroacetabular Impingement: Early Patient Reported Outcomes

Abstract

Many surgical techniques have been described for femoroacetabular impingement (FAI) surgery to help with improvement of pain and function in symptomatic patients. The aim of this study was to evaluate early patient reported outcomes and complications using combined hip arthroscopy and limited open osteochondroplasty technique. We retrospectively analysed 27 hips in 26 patients. Outcomes were assessed using the nonarthritic hip score (NAHS), UCLA score and Visual analogue scale (VAS) pain score. The average age of patients was 31.3 years and they were followed up for an average of 22.3 months. Average improvement of NAHS score was 39.55 points (p<.0001), 18 patients (72%) had at least 30 points increase in NAHS. There was 3 points average improvement in UCLA score (p<.0001). 17 patients (68%) had UCLA activity level of 6 and above. The average improvement of VAS pain score was 27.5 points (p<.0001). Minor complications included neuropraxia of the lateral femoral cutaneous nerve in three patients who recovered at three months with no sequelae, while one patient developed asymptomatic heterotopic ossification Brooker grade I. One patient had neuropraxia of the sciatic nerve which recovered completely within six months. One patient had a conversion to THR at 12 months. This is an effective technique to treat FAI for reducing pain and improving function at short term follow-up and has a low complication rate without appearing to have a significant learning curve. The failure rate can be reduced if proper case selection is done.