Abstract
BackgroundFemoroacetabular impingement (FAI) is associated with decreased hip function and early hip osteoarthritis. Surgical treatment is often required to halt the process of mechanical degeneration. The study investigated the short-to-midterm results of using a modified anterolateral mini-open and arthroscopic osteochondroplasty in the treatment of cam-type FAI.MethodsThirty-six patients (39 hips), with the mean age of 43.6 years, who had cam-type FAI, were operated by a mini-open and arthroscopy-assisted osteochondroplasty via the Watson-Jones interval between 2002 and 2016. Radiographic parameters and Harris hip scores were retrospectively analyzed after a mean follow-up of 44 months.ResultsOf the 39 hips, the mean Harris hip score significantly improved from 61.1 preoperatively to 84.2 postoperatively (P < 0.01). There were nine hips (23%) undergoing total hip arthroplasty (THA) at a mean of 22 months (range, 3~64 months) due to progression of hip osteoarthritis. The 5-year survival for hip preserving was 74.9%. Cox proportional-hazards model showed that age ≥ 55 years (P = 0.03) and preoperative Tönnis stage II (P = 0.02) were independent risk factors for conversion to THA.ConclusionsThe mini-open and arthroscopic approach allowed direct visualization and improved quality of the osteochondroplasty of FAI hip while avoiding the need for surgical dislocation. This technique could be a safe and viable option for symptomatic cam-type FAI patients to relieve symptoms and improve hip function.
Highlights
Femoroacetabular impingement (FAI) is one of the most common causes of groin pain in young adults [1]
The advantages of this approach include both minimal soft tissue invasion and improved quality of the osteochondroplasty by direct visualization on femoral head and neck that would otherwise only be obtained with surgical dislocation [19]
Patients were precluded from this procedure if he or she had (1) advanced hip osteoarthritis, defined as Tönnis stage III [22]; (2) mixed or pincer type FAI, defined as a lateral center-edge (LCE) angle more than 33° and/or acetabular index (AI) less than 3° [21]; or (3) Legg-Calve′-Perthes disease
Summary
Femoroacetabular impingement (FAI) is one of the most common causes of groin pain in young adults [1]. Emerging evidence has shown that FAI is a major cause of acetabular labral and cartilage injuries, and is recognized as a significant contributing factor in the development of early hip osteoarthritis [3, 4]. A symptomatic cam-type FAI possibly warrants more clinical concern and prompt intervention to prevent deterioration of chondral and labral injuries, and the development of hip osteoarthritis. The use of mini-open technique with arthroscopic assistance is less often reported in the literature [18]. The advantages of this approach include both minimal soft tissue invasion and improved quality of the osteochondroplasty by direct visualization on femoral head and neck that would otherwise only be obtained with surgical dislocation [19].
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