Isolated Acetabuloplasty and Labral Repair for Combined-Type Femoroacetabular Impingement: Are We Doing Too Much?

Predictors of Outcomes After Hip Arthroscopic Surgery for Femoroacetabular Impingement: A Systematic Review

“…Four studies reported Tönnis grade 0 as a significant predictor for positive outcomes. 11,20,21,65 Cvetanovich et al 11 found that patients who were preoperatively determined to be Tönnis grade 0 achieved the MCID for the HOS-ADL (OR, 2.49 [95% CI, 1.13-5.44]; P = .022) and the patient acceptable symptom state (PASS) for the HOS-SSS (OR, 2.72 [95% CI, 1.22-6.33]; P = .014) relative to patients with Tönnis grade 1. In patients not requiring revision arthroplasty in the study by Gicquel et al, 21 the only factors associated significantly with the midterm Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were preoperative Tönnis grade ( P = .047) and midterm Tönnis grade ( P = .03).…”

“…Numerous studies reported that a higher preoperatively determined Tönnis grade (≥1) led to more negative outcomes after hip arthroscopic surgery (Table 4). 10,21,28,51,65 The LCEA was also predictive of negative outcomes after hip arthroscopic surgery in 2 studies (Table 4). 7,25 More specifically, Chandrasekaran et al 7 reported a mean LCEA of 45.0° in their study and noted that although arthroscopic interventions significantly improved patient outcomes, patients with an LCEA >40° and coxa profunda did not report as much improvement in comparison with their matched control group with a mean LCEA of 31.3°.…”

Editorial Commentary: Hip Femoroacetabular Impingement Correction: Risk Versus Reward, or How Much Is Too Much?

“…T jong, Gombera, Kahlenberg, Patel, Han, Deshmane, and Terry present their study "Isolated Acetabuloplasty and Labral Repair for Combined-Type Femoroacetabular Impingement: Are We Doing Too Much?," which challenges us to think about what we are doing in the arthroscopic management of symptomatic pathological femoroacetabular impingement (FAI). 1 In a small sense, this illustrates my own personal perspective on the arthroscopic management of FAI as well as the evolution of my philosophy in its management. Keep in mind that FAI is just a concept that explains the pattern of pathology often observed in the hip joint.…”

The Importance of Comprehensive Cam Correction: Radiographic Parameters Are Predictive of Patient-Reported Outcome Measures at 2 Years After Hip Arthroscopy

“…However, this also stands in stark contrast to other research that questions the relative value of femoral-side treatment. In their series of 106 hips with isolated acetabular rim trim and labral repair for combined-type FAI, Tjong and colleagues 26 noted no differences in the International Hip Outcome Tool, mHHS, HOS, and patient satisfaction scale according to preoperative alpha angle, and no cases of revision hip surgery were required at greater than 3-year follow-up. The authors subsequently concluded that alpha angle had limited effect on postoperative outcomes or secondary revision rates, although this study did not report range of motion postoperatively or feature a comparative group with adjunctive femoroplasty.…”