The anterior mini-open approach for femeroacetabular impingement: Gait and functional assessment at one year post-surgery

Malagelada, Francesc; Carmen, Amin Del; Barke, Samuel J.; Cano, Lluis Guirao; Pleguezuelos, Eulogio

doi:10.1016/j.rehab.2014.09.013

Cited by 15 publications

(6 citation statements)

References 28 publications

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“…The mean postsurgery follow-up was 28.1±15.5 months in 89% of studies that reported this variable. Follow-up ranged from 12 months25 28 to 73.2 months 49…”

Section: Resultsmentioning

confidence: 99%

Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: a systematic review with meta-analysis

Reiman

Peters²,

Sylvain

et al. 2018

Br J Sports Med

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“…The mean postsurgery follow-up was 28.1±15.5 months in 89% of studies that reported this variable. Follow-up ranged from 12 months25 28 to 73.2 months 49…”

Section: Resultsmentioning

confidence: 99%

Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: a systematic review with meta-analysis

Reiman

Peters²,

Sylvain

et al. 2018

Br J Sports Med

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“…Besides, neuromuscular adaptations have been reported to influence symptoms and contribute to changes in biomechanical outcomes 19,[29][30][31][32] . Although several studies reported on hip biomechanics in patients from pre-arthritic hip disease 20,27,[33][34][35][36][37] , the effect on musculoskeletal loading in terms of the dynamic muscle forces and hip contact force (HCF) is still limited to gait 32,37,38 with little information during functional ROM. As osteochondroplasty of the cam morphology can decrease joint contact loading by 21-27% 39,40 , a further understanding of changes in muscle forces and their consequent effect on joint loading may provide benefits to design better pre-and/or postoperative FAI rehabilitation programs after corrective FAI surgery 41,42 .…”

Section: Introductionmentioning

confidence: 99%

Hip Muscle Forces and Contact Loading During Squatting After Cam-Type FAI Surgery

Catelli

Wesseling

et al. 2020

Journal of Bone and Joint Surgery

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Background: Corrective hip surgery for cam-type femoroacetabular impingement (FAI) aims to improve hip function and prevent joint degeneration. The purpose was to compare muscle and hip contact forces (HCF) during squatting in cam-FAI patients before and after hip corrective surgery, and in healthy control participants (CTRL).Methods: Ten symptomatic cam-FAI male patients performed deep squatting pre-and at 2 years postoperatively. Patients were age, and body-mass-index matched to 10 CTRL male participants. Full-body kinematics and kinetics were computed and, muscle forces and HCF were estimated using musculoskeletal model and static optimization. Normalized squat cycle (%SC) trials were compared using statistical non-parametric mapping (SnPM). Results: Postoperative patients squatted down with higher anterior pelvic tilt (11-29%SC, P=.004), higher hip flexion (9-31%SC, P=.003) and greater hip extension moments (21-26%SC, P=.008) compared to preoperative FAI. Preoperative patients also demonstrated lower anterior pelvic tilt (7-9%SC, P=.023; 92-99%SC, P=.016) and lower hip flexion (87-97%SC, P=.008) compared to the CTRL. Postoperative patients showed increased semimembranosus force concerning their preoperative values (68-73%SC, P=.002). Preoperative forces were also lower than the CTRL for the adductor magnus (28-34%SC, P=.011), psoas major (49-58%SC, P=.

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“…Several studies have reported good results in the management of patients with FAI using an anterior Hueter approach. 5 , 20 , 29 , 30 However, the anterior Hueter approach might make it difficult to access the subspine space. Cohen et al 7 managed FAI in athletes using a direct mini-open approach and demonstrated significant improvement in functional outcomes.…”

Section: Discussionmentioning

confidence: 99%

Outcomes After Management of Subspine and Femoroacetabular Impingement Using a Direct Anterior Mini-Open Approach

Chen

Peng

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Subspine impingement (SSI) has been commonly managed with arthroscopic decompression. However, arthroscopic decompression is a demanding technique, as under- or over-resection of the anterior inferior iliac spine (AIIS) could lead to inferior outcomes. An anterior mini-open approach has also been used in the management of femoroacetabular impingement (FAI), and it could provide adequate visualization of the anterior hip joint without a long learning curve. Purpose/Hypothesis: The objective of the current study was to compare the outcomes of SSI patients with FAI who underwent arthroscopic subspine decompression and osteoplasty with a group undergoing subspine decompression and osteoplasty using a modified direct anterior mini-open approach. It was hypothesized that there would be no significant difference in outcomes between the groups. Study Design: Cohort study; Level of evidence, 3. Methods: We reviewed the records of SSI patients who underwent decompression surgery (arthroscopic or mini-open) at our institution from June 1, 2015 to December 31, 2016. Both groups underwent the same postoperative rehabilitation protocol. Preoperative and 2-year postoperative patient-reported outcomes were compared using the modified Harris Hip Score (mHHS), International Hip Outcome Tool–33 (iHOT–33), and Hip Outcome Score—Activities of Daily Living (HOS–ADL). Major and minor complications as well as reoperation rates were recorded. Results: Included were 47 patients (49 hips) who underwent subspine decompression using an anterior mini-open approach and 35 patients (35 hips) who underwent arthroscopic subspine decompression. There were no differences in demographic and radiological parameters between the groups, and patients in both groups showed significant improvement in all outcome scores at follow-up. The pre- to postoperative improvement in outcome scores was also similar between groups (mini-open vs arthroscopy: mHHS, 26.30 vs 27.04 [ P = .783]; iHOT–33, 35.76 vs 31.77 [ P = .064]; HOS–ADL, 26.09 vs 22.77 [ P = .146]). In the mini-open group, 10 of the 47 patients had temporary meralgia paresthetica, and fat liquefaction was found in 1 female patient. There were no reoperations in the mini-open group. Conclusion: Subspine decompression using the anterior mini-open approach had similar outcomes to arthroscopic decompression in the management of SSI. The lateral femoral cutaneous nerve should be protected carefully during use of the anterior mini-open approach.

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The anterior mini-open approach for femeroacetabular impingement: Gait and functional assessment at one year post-surgery

Abstract: There was significant reduction in pain intensity 12 months following mini-open approach for FAI compared to preoperatively. Improvement in gait analysis and functional capacity was also seen, although not statistically significant.

Cited by 15 publications

References 28 publications

Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: a systematic review with meta-analysis

Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: a systematic review with meta-analysis

Hip Muscle Forces and Contact Loading During Squatting After Cam-Type FAI Surgery

Outcomes After Management of Subspine and Femoroacetabular Impingement Using a Direct Anterior Mini-Open Approach

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