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Hip arthroscopy with initial access to the peripheral compartment provides significant improvement in FAI patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study was designed to evaluate the clinical and radiographic results of arthroscopic treatment of femoroacetabular impingement (FAI) using the technique of initial access to the peripheral compartment. It is based on a single surgeon large case series with a minimum of 2 years follow-up.

Methods

Prospective longitudinal study with consecutive patients. Inclusion criteria were the presence of FAI syndrome that had failed non-operative treatment and had a hip arthroscopy with initial access to the peripheral compartment. Exclusion criteria were previous hip surgery, patients younger than 16 or older than 60 years, Tönnis grade ≥ 2 osteoarthritis, hip dysplasia based on radiographic evidence of LCEA less than 25° and workers compensation cases. One hundred and sixty hips met the inclusion criteria, 84 were female and 70 were male patients (six bilateral cases), with a median age of 36 years (range 16–59).

Results

The median alpha angle correction was 22.6º (range 5.9–46.7) (p < 0.01) and the average LCEA correction when acetabuloplasty was undertaken was 6.5º (range − 1.4–20.8) (p < 0.01). The mean NAHS at baseline was 56.1 (range 16–96) and improved to 83.2 at the last follow up (range 44–100) for the patients that had no additional procedure (p < 0.01). The mean average improvement was 27.7º points (range − 16–73). No iatrogenic labral perforation and no full-thickness chondral damage were recorded during the arthroscopic procedures.

Conclusions

Favourable outcomes are reported for the arthroscopic treatment of FAI with initial access to the peripheral compartment. The technique is protective against iatrogenic chondral and labral damage, more conservative to the joint capsule, but the mean traction time was relatively long when suture anchors were used. The results are comparable to the classic initial central compartment approach.

Level of evidence

Level IV.

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Author information

Authors and Affiliations

  1. Centro Hospitalar Universitário Lisboa Central, Lisboa, Portugal

    Pedro Dantas & Sérgio Gonçalves

  2. Hospital CUF Descobertas, Rua Mário Botas, 1998-018, Lisboa, Portugal

    Pedro Dantas & Sérgio Gonçalves

  3. Hospital da Luz, Lisboa, Portugal

    Vasco Mascarenhas

  4. Policlinico Di Abano Terme, Pádua, Italy

    Antonio Camporese

  5. University Hospital Infanta Leonor, Madrid, Spain

    Oliver Marin-Peña

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  1. Pedro Dantas
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  2. Sérgio Gonçalves
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  5. Oliver Marin-Peña
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Correspondence to Pedro Dantas.

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Conflict of interest

One author of this paper is consultant for Depuy and Smith & Nephew and another author is consultant for Depuy, Heraeus, 3M and MBA.

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No external grants or funding was obtained for this study.

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The study was approved by the institutional review board of the Hospital CUF Descobertas (ID number: JMS/is 58).

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Dantas, P., Gonçalves, S., Mascarenhas, V. et al. Hip arthroscopy with initial access to the peripheral compartment provides significant improvement in FAI patients. Knee Surg Sports Traumatol Arthrosc 29, 1453–1460 (2021). https://doi.org/10.1007/s00167-020-06380-z

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