Background
Femoroacetabular impingement (FAI) is a recognized cause of intra-articular pathology and secondary osteoarthritis in young adults. Arthroscopy is reportedly useful in the treatment of selected hip abnormalities and has been proposed as a method for correcting underlying impingement. The aim of this study was to evaluate the early outcomes of arthroscopic management of FAI.
Patients and methods
Thirty-four consecutive patients with clinically and radiographically documented FAI were treated with hip arthroscopy, proximal femoral osteoplasty, labral debridement or repair/ refixation, or acetabuloplasty or some combination. Outcomes were measured using the impingement test, Harris Hip Score, pain score on a visual analogue scale, and radiologically preoperatively and postoperatively at 6 weeks, 3 months, 6 months, 1 year, 2 years, and 3 years.
Results
There were 25 male patients and nine female patients with up to 3 years of follow-up (mean 20.6 months). The mean age of the patients was 34.2 years. Isolated cam impingement was identified in 16 hips, pincer impingement was found in six, and both types were noted in 12. Three hips were subjected to labral repair and fixation. A comparison of preoperative scores with those obtained at the most recent follow-up indicated a significant improvement ( < 0.05) for all outcomes measured: Harris Hip Score (59.7 vs. 82.9), visual analogue scale score for pain (6.81 vs. 1.81), and positive impingement test (100 vs. 11.76%). The β angle was also significantly improved after resection femoroplasty. Complications included heterotopic bone formation (one hip), four patients with nerve neuropraxia, and two hips have subsequently been subjected to total hip arthroplasty.
Conclusion
Arthroscopic management of patients with FAI results in a significant improvement in outcomes measures and is comparable with open techniques, with advantages of minimally invasive procedures.
Level of evidence
Level IV. Therapeutic study.