Abstract
Pincer impingement is often treated by surgical labral separation from the acetabular rim and rim reduction. A more recent technique the so-called ‘over the top’ involves reduction of the bony acetabular rim without separation of the labrum. Our purpose is to report mid-term results of the ‘over the top’ technique. Between January 2006 and January 2013 a consecutive series of patients with femoroacetabular impingement (FAI) diagnosis, treated with the ‘over the top’ technique were included, using the lateral approach. The Western Ontario and MacMaster (WOMAC) scores were evaluated. Fifty patients (20 males and 30 females) from the Hip and Knee Joint Reconstructive and hip arthroscopy division were included. The average age was 30.5 years old and the average follow-up was 48 months (range 70–90). Preoperative WOMAC average was 42. Post-operative WOMAC was 81.3 (P = 0.01). One patient required an arthroscopic revision due to adherences, but had a full recovery after the revision surgery. The ‘over the top’ technique is an excellent choice for the treatment of the pincer deformity in the FAI avoiding the injury of the chondrolabral union.
Highlights
The concept of femoroacetabular impingement (FAI) has evolved considerably and is accepted as an important factor related to hip pain and a probable cause of hip osteoarthritis [1]
The ‘over the top’ technique is an excellent choice for the treatment of the pincer deformity in the FAI avoiding the injury of the chondrolabral union
Recent literature compares open versus arthroscopic treatment [4, 5], concluding that both were associated with clinical improvement
Summary
The concept of femoroacetabular impingement (FAI) has evolved considerably and is accepted as an important factor related to hip pain and a probable cause of hip osteoarthritis [1]. The first described treatment was proposed by Ganz et al [2] and consisted of a controlled open surgical dislocation and remodeling of the impinging deformities with good initial clinical results. Hip arthroscopy has been recognized as a standard procedure in the treatment of FAI [3]. Recent literature compares open versus arthroscopic treatment [4, 5], concluding that both were associated with clinical improvement. Botser et al [5] suggest that hip arthroscopy is associated with a faster recovery and less complications. Mid-term results for arthroscopic treatment of FAI have been reported ranging from good to excellent [6, 7]
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