Skip to main content
SpringerLink
Log in

Groin Pain after Open FAI Surgery: The Role of Intraarticular Adhesions

  • Symposium: Femoroacetabular Impingement: Current Status of Diagnosis and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Femoroacetabular impingement (FAI) is an established cause of osteoarthrosis of the hip. Surgery is intended to remove the cause of impingement with hip dislocation and resection of osseous prominences of the acetabular rim and of the femoral head-neck junction. Using the Merle d’Aubigné score and qualitative categories, recent studies suggest good to excellent outcomes in 75% to 80% of patients after open surgery with dislocation of the femoral head. Unsatisfactory outcome is mainly related to pain, located either in the area of the greater trochanter or in the groin. There are several reasons for persisting groin pain. Joint degeneration with joint space narrowing and/or osteophyte formation, insufficient correction of the acetabula, and femoral pathology are known factors for unsatisfactory outcome. Recently, intraarticular adhesions between the femoral neck and joint capsule have been identified as an additional cause of postoperative groin pain. The adhesions form between the joint capsule and the resected area on the femoral neck and may lead to soft tissue impingement. MR-arthrography is used for diagnosis and the adhesions can be treated successfully by arthroscopy. While arthroscopic resection improves outcome it is technically demanding. Avoiding the formation of adhesions is important and is perhaps best accomplished by passive motion exercises after the initial surgery.

Level of Evidence: Level V, expert opinion. See the Guidelines for Authors for a complete description of levels of evidence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4A–B
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Allison RT. Foreign body reactions and an associated histological artifact due to bone wax. Br J Biomed Sci. 1994;51:14–17.

    PubMed  CAS  Google Scholar 

  2. Beaule PE, Le Duff MJ, Zaragoza E. Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am. 2007;89:773–779.

    Article  PubMed  Google Scholar 

  3. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87:1012–1018.

    Article  PubMed  CAS  Google Scholar 

  4. Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: Part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.

    Article  PubMed  Google Scholar 

  5. Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am. 2007:89 Suppl 2:36–53.

    Google Scholar 

  6. Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: Preliminary results of labral refixation. J Bone Joint Surg Am. 2006;88:925–935.

    Article  PubMed  Google Scholar 

  7. Ferguson SJ, Bryant JT, Ganz R, Ito K. An in vitro investigation of the acetabular labral seal in hip joint mechanics. J Biomech. 2003;36:171–178.

    Article  PubMed  CAS  Google Scholar 

  8. Ganz R, Gill TJ, Gautier E, Ganz K, Krugel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83:1119–1124.

    Article  PubMed  CAS  Google Scholar 

  9. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: A cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.

    PubMed  Google Scholar 

  10. Haupt U, Völkle D, Waldherr C, Beck M. Intra- and retroperitoneal irrigation liquid after arthroscopy of the hip joint. Arthroscopy. 2008;24:966–968.

    PubMed  Google Scholar 

  11. Heyworth BE, Shindle MK, Voos JE, Rudzki JR, Kelly BT. Radiologic and intraoperative findings in revision hip arthroscopy. Arthroscopy. 2007;23:1295–1302.

    PubMed  Google Scholar 

  12. Ito K, Minka MA II, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83:171–176.

    Article  PubMed  CAS  Google Scholar 

  13. Krueger A, Leunig M, Siebenrock KA, Beck M. Hip arthroscopy after previous surgical hip dislocation for femoroacetabular impingement. Arthroscopy. 2007;23:1285–1289.

    Article  PubMed  Google Scholar 

  14. Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement: Part I. Techniques of joint preserving surgery. Clin Orthop Relat Res. 2004;418:61–66.

    Article  PubMed  Google Scholar 

  15. Murphy S, Tannast M, Kim YJ, Buly R, Millis MB. Débridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results. Clin Orthop Relat Res. 2004;429:178–181.

    Article  PubMed  Google Scholar 

  16. Philippon MJ, Schenker ML, Briggs KK, Kuppersmith DA, Maxwell RB, Stubbs AJ. Revision hip arthroscopy. Am J Sports Med. 2007;35:1918–1921.

    Article  PubMed  Google Scholar 

  17. Werlen S, Leunig M, Ganz R. Magnetic resonance arthrography of the hip in femoroacetabular impingement: technique and findings. Operat Tech Orthop. 2005;15:191–203.

    Article  Google Scholar 

  18. Wettstein, Dienst M. Hip arthroscopy for femoroacetabular impingement [in German]. Orthopäde. 2006;35:85–93.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Bern, Inselspital, Bern, Switzerland

    Martin Beck MD

  2. Department of Orthopaedics, Luzerner Kantonsspital, 6000, Luzern, Switzerland

    Martin Beck MD

Authors
  1. Martin Beck MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Beck MD.

Additional information

The author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

The author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

About this article

Cite this article

Beck, M. Groin Pain after Open FAI Surgery: The Role of Intraarticular Adhesions. Clin Orthop Relat Res 467, 769–774 (2009). https://doi.org/10.1007/s11999-008-0653-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-008-0653-1

Keywords

Search

Navigation