Results of Arthroscopic Treatment of Patients With Femoroacetabular Impingement Depending on the Type of Hip Deformity

Abstract

Relevance.
 Femoroacetabular impingement (FAI) is one of the most common causes of pain and limitation of mobility in the hip joint in young and middle-aged individuals.
 The purpose of the study.
 The purpose of the study was to assess the effect of different hip deformities on the patient-reported outcome, to determine the influence of the structure of the acetabulum in conditions of borderline developmental dysplasia of the hip (BDDH) on the result of arthroscopy.
 Materials and methods.
 A retrospective, uncontrolled, single-center clinical trial was performed. It included 121 patients (40.5% female, and 59.5% male) who underwent arthroscopy on 135 hips. All patients underwent physical examination, hip radiographs and MRI. In patients with BDDH, the acetabulum version was evaluated. The i-HOT-33 and HOS scales were used pre- and postoperatively. Patients were divided into 4 groups according to the type of deformity.
 Outcomes.
 The best results were obtained from patients with isolated Cam deformity (group 1). The results of patients with a mixed type of deformity (group 2) did not differ from group 1 according to the HOS but differed according to i-HOT-33. The results of patients with a combination of Cam deformity, BDDH, and retroversion (group 4) did not differ from the group 1. In the group of patients with a combination of Cam deformity and BDDH (group 3), according to the HOS-Sport, a substantial clinical benefit (SCB) was achieved in 30%, while in the remaining groups it was not lower than 58%. First 2 postoperative years all patients show a significant improvement, but then, there is a downward trend in the performance of groups 2 and 3.
 Conclusion.
 The best results of arthroscopy are shown by patients with isolated Cam-deformity, patients with mixed type of FAI show slightly worse results. In conditions of BDDH, the effectiveness of arthroscopy depends on the structure of the anterior wall of the acetabulum. The worst results are observed in patients with BDDH and insufficiently developed anterior wall of the acetabulum, in the treatment of these patients it may be necessary to give preference to isolated, or in combination with arthroscopy, periacetabular osteotomy.