Does Arthroscopic FAI Correction Improve Function with Radiographic Arthritis?

Abstract

Background Previous studies reporting the impact of osteoarthritis (OA) on pain and function after hip arthroscopy largely predate resection of femoroacetabular impingement (FAI). Questions/purposes We determined (1) functional improvement after resection of FAI impingement lesions in patients with preoperative radiographic joint space narrowing, and (2) identified preoperative predictors of pain, function, and failure rates in these patients.

Do Professional Athletes Perform Better Than Recreational Athletes After Arthroscopy for Femoroacetabular Impingement?

“…The arthroscopic approach has the benefit of less soft tissue damage leading to quicker rehabilitation and also is safer for the patients [4]. Even in patients with milder degrees of preoperative degenerative change on their radiographs, after osteochondroplasty for FAI, an improvement in pain and function has been demonstrated at followup from 12 to 60 months [19]. An acetabular labral tear is described as the most common pathology for which hip arthroscopy may be indicated and selective débridement of these tears leads to improvement in HHS at 10 years in 83% of patients without associated arthritis [8].…”

Intraoperative Cartilage Degeneration Predicts Outcome 12 Months After Hip Arthroscopy

“…A large number of patients undergoing hip arthroscopy have degenerative changes attributable to osteoarthritis (OA) in the joint. For example, 63% of a cohort of patients treated with arthroscopy was found to have acetabular articular cartilage lesions [17], and 88% of patients who did not have significant OA observed on preoperative radiographs before having arthroscopic femoroacetabular impingement (FAI) correction had intraoperative acetabular cartilage lesions [14]. Cartilage degeneration can occur at both articular surfaces of the femur and acetabulum and also the acetabular rim cartilage or labrum.…”

“…The findings have led to the use of hip arthroscopy generally being supported in cases where OA is mild to moderate [13,17,22], whereas severe OA has been seen as a contraindication [3,14,16]. Arthroscopic surgical techniques and instrumentation have undergone major changes during the past decade.…”

CORR Insights®: Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection

“…Should early surgical intervention be recommended? Some studies have tried to answer this question in the affirmative, based on poorer outcomes among patients with longer duration of symptoms [1,8]. However, this implies that those with longer duration of symptoms would have been better off had they been operated on earlier, which is not a conclusion that can be drawn based on this observation alone.…”