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A novel concept of cam-type femoroacetabular impingement treatment with patient-specific template guided osteochondral deformity ablation

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Abstract

Purpose

To present a novel surgical concept for the cam-type femoroacetabular impingement (FAI) treatment and to assess and report the clinical outcomes.

Methods

We performed a retrospective study of a single-surgeon case series of six hips in five consecutive male patients with symptomatic cam-type FAI, treated with the mini-open anterior hip approach with a patient-specific template (PST)-guided deformity ablation between 2015 and 2018. We assessed the hip range of motion, iHOT-33, Tegner, and EQ-5D before surgery and after a minimum follow-up of 30 months.

Results

The average age was 37 ± 13.3 years, average BMI was 31.1 ± 3.3 kg/m2, and average pre-surgery Tönnis hip osteoarthritis (OA) grade was 1 ± 1. The average surgery duration was 71 ± eight minutes. The average estimated blood loss was 83 ± 26 ml. After a mean follow-up of 50 ± 12 months, we observed no OA progression with no change in Tönnis hip OA grades. Hip flexion and internal rotation significantly improved (p = 0.007; p = 0.048) from mean 98° ± 9° and 14° ± 11° to mean 113° ± 8° and 23° ± 8°, respectively. iHOT-33, Tegner, and EQ-5D improved significantly (p = < 0.001; p = 0.004; p = < 0.001) from mean 44.7 ± 12.2, 3 ± 1, and 0.513420 ± 0.101389 to mean 94 ± 2.7, 5 ± 1, and 1.000000 ± 0, respectively. One patient needed revision surgery for heterotopic ossification removal, with no sequelae at the last follow-up.

Conclusion

Mini-open anterior hip approach with the PST-guided cam-type FAI deformity ablation presents an accurate and reproducible solution for cam-type FAI surgical treatment, with promising clinical outcomes. Using a PST in the cam-type FAI surgery may present a powerful additional tool in the existing open techniques armamentarium.

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Data availability

Raw data (clinical, radiography) were generated at the Valdoltra Orthopaedic Hospital, Ankaran, Slovenia. Derived anonymized data supporting findings of this study are available from the corresponding author upon request.

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Valdoltra Orthopaedic Hospital, Jadranska cesta 31, 6280, Ankaran, Slovenia

    Rene Mihalič, Peter Brumat & Rihard Trebše

  2. Chair of Orthopaedics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Rihard Trebše

Authors
  1. Rene Mihalič
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  2. Peter Brumat
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Correspondence to Rene Mihalič.

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The authors declare that they have no conflict of interest.

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The study was approved by the Ethics Committee of the Valdoltra Orthopaedic Hospital (No. 14/2020).

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All patients provided written informed consent for their participation in the study.

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Written informed consent was obtained from patients for their anonymized data to be published in this article.

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Mihalič, R., Brumat, P. & Trebše, R. A novel concept of cam-type femoroacetabular impingement treatment with patient-specific template guided osteochondral deformity ablation. International Orthopaedics (SICOT) 45, 907–913 (2021). https://doi.org/10.1007/s00264-020-04887-1

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