Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

Abstract

ObjectivesTo evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach.MethodsBetween January 2011 and March 2012, 49 patients (50 hips) underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips) fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS), the Non-Arthritic Hip score (NAHS) and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip.ResultsOut of the 41 hips treated, 31 (75.6%) presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001). Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001).ConclusionArthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

Open versus arthroscopic approach in the treatment of femoroacetabular impingement: a case–control study with two-years follow up

“…Complications are usually related to the time of more frequent injuries such as those of the lateral pudendal and lateral femoral cutaneous nerves, and rarer injuries such as to the sciatic nerve (0–12.9%). 1 , 10 , 11 , 12 , 20 Phillipon et al 11 used the arthroscopic technique for FAI treatment in 112 patients (mean follow-up of 2.3 years) and found a mean increase of 24 points in the MHHS, without complications. In a recent publication, Bryrd and Jones 10 evaluated 207 hips (mean follow-up of 16 months) and found a mean increase of 20 points in the MHHS; complications were observed in 1.5% of cases and in 0.5% of cases progressed to total hip arthroplasty.…”

“…This was a retrospective case–control study that included patients who underwent arthroscopic and open FAI treatment, performed by the Hip Surgery Group, operated consecutively between November 2007 and March 2012. During this period, 62 patients (64 hips) underwent this treatment; all arthroscopic surgeries were performed by the same surgeon (BDR) through the extracapsular approach 12 and, similarly, all open surgeries were performed by the same surgeon (MVR) through the iliofemoral approach. Exclusion criteria for this study were: patients with isolated pincer-type IFA (four cases), losses to follow-up (one case), and follow-up of less than two years (one case).…”

Arthroscopic subcapital realignment osteotomy in chronic and stable slipped capital femoral epiphysis: early results

“…The arthroscopic approach used for subcapital realignment was extracapsular, 10 following the access to the peripheral joint compartment described by Sampson. 11 …”

Anterior inferior iliac spine avulsion fracture post hip arthroscopy for Femoroacetabular impingement

“…It is also a cause of osteoarthritis of the hips [ 3 ]. This condition presents a major cause of degenerative hip outcome [ 4 ]. Previously, the standard treatments of FAI was surgical hip dislocation and open osteochondroplasty [ 5 ].…”