Retrospective Analysis of Arthroscopic Cam Decompression. Is Hip Joint Still Preserved Although at Learning Curve?

Abstract

INTRODUCTION: Hip arthroscopy is an effective treatment for femoroacetabular impingement (FAI). Purpose of the present study was to report the patient reported outcomes, hip survival retrospectively at a mean follow-up of five years. METHODS: Retrospectively collected data on 25 patients with FAI at minimum follow-up of 42 months (mean 60 months) treated with hip arthroscopy and labrum repair were analyzed. The primary outcome measures were the Hip Outcome Score (HOS) Activities of Daily Living (ADL) subscale, HOS-Sport subscale, Visual analog scale (VAS) for pain. Patient satisfaction was rated. Measurement of joint spaces and osteoarthritis (Tonnis) grading were done preoperatively and at the latest follow-up RESULTS: Pre- and postoperative mean alpha angles were 670±40 and 460±30. %76 of patients achieved minimal clinically important difference (MCID) for HOSADL and %56 of patients achieved MCID for HOSSS and all reached MCID for VAS pain score. Mean satisfaction level was 7.5±1.8 Mean preoperative Tonnis stage of the patients was 0.9±0.9 which increased to 1.1±0.8 (p: 0.046). Mean preoperative lateral joint space was 4.8±1 which decreased to 4.5±1 p<0.001. Mean middle joint space also decreased from 4.5±0.9 to 4.3±0.7 (p: 0.04). However this decrease was not statistically significant at joint space measured at foveal level (p˃0.05) (5±0.8 vs 4.9±0.7). DISCUSSION AND CONCLUSION: Mid-term results show that that after cam decompression, it is possible to say that hip joint is at least preserved and progression of hip osteoarthritis seems to be delayed. Patient functional results, pain scores are generally improved in line with the literature Keywords: hip arthroscopy, osteoarthritis, hip impingement