Arthroscopic Treatment of Cam-Type Femoroacetabular Impingement

Ilizaliturri, Víctor M.; Orozco-Rodriguez, Liliana; Acosta-Rodriguez, Eduardo; Camacho-Galindo, Javier

doi:10.1016/j.arth.2007.03.016

Cited by 160 publications

(128 citation statements)

References 15 publications

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“…However, Larson et al [21] reported superior results in pain reduction (using the visual analog scale) comparing labral reattachment and resection after hip arthroscopy. At followup, we found comparable results for the WOMAC [1,16,29], HHS [6,21,23,33,34], SF-12 [1,29], and UCLA [1] scores reported in the literature for studies with a variable percentage of labral reattachment (Table 6). decreased total femoral coverage or increased extrusion index.…”

Section: Discussionsupporting

confidence: 70%

“…In a study using computer-animated hip motion, decreased abduction was found for hips with FAI along with decreased internal rotation in flexion [41]. Improved clinical scores have been found for both labral reattachments and resection (Table 6) [1,5,11,16,21,23]. Espinosa et al [11] found a superior Merle d'Aubigné-Postel score for hips with labral reattachment compared with labral resection after surgical hip dislocation.…”

Section: Discussionmentioning

confidence: 97%

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Surgical Hip Dislocation for Treatment of Femoroacetabular Impingement: Factors Predicting 5-year Survivorship

Steppacher

Huemmer

Schwab

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Patients with femoroacetabular impingement (FAI) often develop pain, impaired function, and progression of osteoarthritis (OA); this is commonly treated using surgical hip dislocation, femoral neck and acetabular rim osteoplasty, and labral reattachment. However, results with these approaches, in particular risk factors for OA progression and conversion to THA, have varied. Questions/purposes We asked if patients undergoing surgical hip dislocation with labral reattachment to treat FAI experienced (1) improved hip pain and function; and (2) prevention of OA progression; we then determined (3) the survival of the hip at 5-year followup with the end points defined as the need for conversion to THA, progression of OA by at least one Tönnis grade, and/or a Merle d'Aubigné-Postel score less than 15; and calculated (4) factors predicting these end points. Methods Between July 2001 and March 2003, we performed 146 of these procedures in 121 patients. After excluding 35 patients (37 hips) who had prior open surgery and 11 patients (12 hips) who had a diagnosis of Perthes disease, this study evaluated the 75 patients (97 hips, 66% of the procedures we performed during that time) who had a mean followup of 6 years (range, 5-7 years). We used the anterior impingement test to assess pain, the Merle d'Aubigné-Postel score to assess function, and the Tönnis grade to assess OA. Survival and predictive factors were calculated using the method of Kaplan and Meier and Cox regression, respectively. Results The proportion of patients with anterior impingement decreased from 95% to 17% (p \ 0.001); the Merle d'Aubigné-Postel score improved from a mean of 15 to 17 (p \ 0.001). Seven hips (7%) showed progression of OA and another seven hips (7%) converted to THA Survival free from any end point (THA, progression of OA, or a Merle d'Aubigné-Postel \ 15) of well-functioning joints at 5 years was 91%; and excessive acetabular rim trimming, preoperative OA, increased age at operation, and weight were predictive factors for the end points. Conclusions At 5-year followup, 91% of patients with FAI treated with surgical hip dislocation, osteoplasty, and labral reattachment showed no THA, progression of OA, or an insufficient clinical result, but excessive acetabular trimming, OA, increased age, and weight were associated with early failure. To prevent early deterioration of the joint, excessive rim trimming or trimming of borderline dysplastic hips has to be avoided.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 97%

Surgical Hip Dislocation for Treatment of Femoroacetabular Impingement: Factors Predicting 5-year Survivorship

Steppacher

Huemmer

Schwab

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Additionally, the surgical techniques utilized in the different studies vary. Open [4,6,14,16,29,30,35], combined arthroscopic and limited open [12,24], and arthroscopic surgical approaches [2,8,9,15,19,[21][22][23][31][32][33] are summarized in this review. This introduces limitations in making general conclusions because each surgical technique may have unique issues related to clinical outcomes and complications.…”

Section: Discussionmentioning

confidence: 99%

“…These techniques include surgical dislocation of the hip [4,6,14,16,29,30], periacetabular osteotomy [35], combined hip arthroscopy and a limited open exposure [12,20,24], and all other arthroscopic techniques [2,8,9,19,[21][22][23][31][32][33]. The goals of these surgical interventions are to relieve pain, enhance activity and function, and preserve the natural hip over time [3].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of Femoroacetabular Impingement: A Systematic Review of the Literature

Clohisy

John

Schutz

2010

Clinical Orthopaedics &Amp; Related Research

267

203

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The surgical treatment of femoroacetabular impingement has become more common, yet the strength of clinical evidence to support this surgery is debated. We performed a systematic review of the literature to (1) define the level of evidence regarding hip impingement surgery; (2) determine whether the surgery relieves pain and improves function; (3) identify the complications; and (4) identify modifiable causes of failure (conversion to total hip arthroplasty). We searched the literature between 1950 and 2009 for all studies reporting on surgical treatment of femoroacetabular impingement. Studies with clinical outcome data and minimum two year followup were analyzed. Eleven studies met our criteria for inclusion. Nine were Level IV and two were Level III. Mean followup was 3.2 years; range (2-5.2 years). Reduced pain and improvement in hip function were reported in all studies. Conversion to THA was reported in 0% to 26% of cases. Major complications occurred in 0% to 18% of the procedures. Current evidence regarding femoroacetabular impingement surgery is primarily Level IV and suggests the various surgical techniques are associated with pain relief and improved function in 68-96% of patients over short-term followup. Long-term followup is needed to determine survivorship and impact on osteoarthritis progression and natural history.

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“…These patients may require joint arthroplasty in the short to medium term [93,94]. Hip arthrodesis is less commonly used today due to advances in arthroplasty technique, but may be considered in selected young adults [56].…”

Section: Hip Arthrodesis and Arthroplastymentioning

confidence: 99%