Open Surgical Dislocation Versus Arthroscopy for Femoroacetabular Impingement: A Comparison of Clinical Outcomes

Botser, Itamar B.; Smith, Thomas W.; Nasser, Rima; Domb, Benjamin G.

doi:10.1016/j.arthro.2010.11.008

Cited by 290 publications

(213 citation statements)

References 46 publications

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“…In 1 study, the evidence supporting arthroscopic treatment of FAI was fair [7]. Other studies looking at combined open and arthroscopic approaches found that the majority of patients improved regardless of the surgical approach, with pain relief in 68 %-96 % of patients, and no significant differences for eventual outcomes based on the surgical approach [8][9][10]. Based on the limited information with regards to specific diagnosis for the studies reviewed, it is difficult to state whether the patients undergoing arthroscopic and open surgical procedures were comparable with respect to pathomorphologies.…”

Section: The Femurmentioning

confidence: 82%

“…Coxa vara, coxa breva, femoral retroversion, and greater trochanteric overgrowth/prominence all increase the degree of cam/proximal femoral-type FAI. Systematic reviews have been performed looking at the efficacy of both open and arthroscopic FAI corrective procedures [7][8][9][10][11]. In 1 study, the evidence supporting arthroscopic treatment of FAI was fair [7].…”

Section: The Femurmentioning

confidence: 99%

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Current concepts and trends for operative treatment of FAI: hip arthroscopy

Larson

Stone

2013

Curr Rev Musculoskelet Med

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There has been an increasing body of literature regarding arthroscopic management of femoroacetabular impingement (FAI). Refinement of arthroscopic techniques has allowed for more complete management of FAI, and metaanalysis and systematic reviews have shown comparable outcomes to surgical hip dislocation with appropriate indications. There are still, however, pathomorphologies that are not accessible or much more challenging to address arthroscopically, and open corrective procedures should be considered in these situations. Extra-articular FAI is receiving increased attention and can be secondary to anterior inferior iliac spine/subspine impingement, trochanteric-pelvic impingement, and ischiofemoral impingement. Femoral and acetabular version and their impact on hip stability as well as the concept of impingement induced instability are being increasingly recognized. Acetabular labral and capsular management and repair techniques have also received increased attention. Finally, 3-dimensional imaging and dynamic software analysis are beginning to emerge as potential tools to better evaluate hip pathomorphology.

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Section: The Femurmentioning

confidence: 82%

Section: The Femurmentioning

confidence: 99%

Current concepts and trends for operative treatment of FAI: hip arthroscopy

Larson

Stone

2013

Curr Rev Musculoskelet Med

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“…and 45% of open FAI cases [12]. As a result of extent, location, and available tissue, some tears can be difficult to repair.…”

Section: Background Rationale and Study Findingsmentioning

confidence: 99%

No Regeneration of the Human Acetabular Labrum After Excision to Bone

Miozzari

Celia

Clark

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Treatment options for a symptomatic, torn, irreparable, or completely ossified acetabular labrum are limited to either excision and/or reconstruction with grafts. In a previous animal model, regeneration of the acetabular labrum after excision to the bony rim has been shown. In humans, less is known about the potential of regeneration of the labrum. Recent studies seem to confirm labral regrowth, but it is still unclear if wide excision might be a surgical option in cases where repair is not possible.Questions/purposes The purposes of this study were (1) to determine the extent of acetabular labrum regeneration after excision to the bony rim; and (2) to determine whether this procedure results in higher hip scores. Methods We reviewed all patients treated with surgical dislocation for symptomatic femoroacetabular impingement by a single surgeon at one institution between 2003 and 2008, of whom 14 underwent wide labral excision (of at least 60°) down to bone; we used this approach when there was an absence of reparable tissue. Of these 14, nine were available for voluntary reexamination. The mean age at surgery was 38 ± 9 SD years and the mean followup was 4 ± 1 SD years. All patients consented to a physical examination and an MRI arthrogram, which was evaluated for evidence of new tissue formation by four observers. A modified Harris hip score and the UCLA were recorded.

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“…However, a change in the natural history of a disorder is not necessarily required in order to support treatment of the disorder. Instead, improvement in outcomes and quality of life should suffice, and systematic reviews evaluating surgical treatment of FAI support these improvements [3,6,8,14,18,20]. I do believe a modest and evidence based approach is critical and that a promising research foundation exists thus far.…”

mentioning

confidence: 99%

The Myths of Femoroacetabular Impingement

Bernstein

2014

Clin Orthop Relat Res

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Open Surgical Dislocation Versus Arthroscopy for Femoroacetabular Impingement: A Comparison of Clinical Outcomes

Cited by 290 publications

References 46 publications

Current concepts and trends for operative treatment of FAI: hip arthroscopy

Current concepts and trends for operative treatment of FAI: hip arthroscopy

No Regeneration of the Human Acetabular Labrum After Excision to Bone

The Myths of Femoroacetabular Impingement

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