Outcomes of hip arthroscopy for femoroacetabular impingement: The effect of morphological type and chondrolabral damage.

Mohammad A. Masoud,Mohamed Mohamed Abdel-Hamid Morsi,Hatem Galal Said,Maher A. El-Assal

doi:10.1051/sicotj/2019012

Mohammad A. Masoud, Mohamed Mohamed Abdel-Hamid Morsi + Show 2 more

Open Access

https://doi.org/10.1051/sicotj/2019012

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Journal: SICOT-J	Publication Date: Jan 1, 2019
Citations: 4	License type: CC BY 4.0

Affiliation: Assiut University

Abstract

Introduction: Hip arthroscopy for treatment of femoroacetabular impingement (FAI) has shown significant pain and functional improvement. However, the differential outcome of each of the FAI morphological types in contrast to one another remains largely unknown. This study was conducted to detect a possible difference in outcome among different FAI types treated using hip arthroscopy. Methods: In this prospective non randomized comparative study, after exclusion of non-FAI cases and cases with advanced arthritic changes, 90 hips in 85 patients that had hip arthroscopy for the treatment of FAI between 2011 and 2015 in our center were analyzed. The collected patient reported outcome measures (PROMs) included visual analog scale (VAS) of pain, the modified Harris hip score (mHHS), and the non arthritic hip score (NAHS) both preoperatively and at final follow-up. Patient satisfaction was collected at final follow-up. Postoperative PROMs were subjected to three main comparisons based on each of FAI type, labral procedure, and extent of cartilage damage. Repeat comparison based on FAI type after matching of exact chondrolabral condition was also attempted. Results: Mean follow-up was 32.8 months (five patients lost from follow-up). There was a significant improvement in the overall PROMs. This improvement was significantly higher in the cam group in contrast to the mixed group. After matching for chondrolabral condition, this difference was consistent and more evident. Discussion: The outcome of arthroscopic treatment of pure cam FAI is significantly better than that of mixed FAI. Matching of the same chondrolabral condition and repeating the comparison yields similar results.

Highlights

Femoroacetabular impingement (FAI), a relatively recent clinical entity, has been presented as the cause for hip pain and idiopathic osteoarthritis in non-dysplastic hips [1]
Arthroscopic FAI surgery has resulted in significant pain relief, improvement in patient reported outcome measures (PROMs), function, and patient satisfaction [7]
The current study shows an overall improvement in PROMs and satisfaction for FAI patients as a whole

Summary

Introduction

Femoroacetabular impingement (FAI), a relatively recent clinical entity, has been presented as the cause for hip pain and idiopathic osteoarthritis in non-dysplastic hips [1]. It describes abnormal contact between the acetabular rim and the femoral head neck junction as a result of deformity of the latter rendering the head less spherical (cam impingement) or overhanging acetabular rim (pincer impingement). Cam and pincer coexist comprising what is called the mixed FAI [1] These morphological aberrations can be secondary to childhood conditions such as slipped capital femoral epiphysis or Perthe’s disease.

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