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Femoroacetabular Impingement Treatment Using Arthroscopy and Anterior Approach

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

Abstract

Femoroacetabular impingement (FAI) has been identified as a common cause of hip pain in young adults. However, treatment is not well standardized. We retrospectively reviewed 97 patients (100 hips) who underwent osteochondroplasty of the femoral head-neck for FAI using a mini-open anterior Hueter approach with arthroscopic assistance. The mean age of the patients was 33.4 years. The labrum was refixed in 40 hips, partially excised in 39 cases, completely excised in 14 cases, and left intact in seven. Six patients were lost to followup, leaving 91 (94 hips) with a minimum followup of 28.6 months (mean, 58.3 months; range, 28.6–104.4 months). We assessed patients clinically using the nonarthritic hip score (NAHS). One patient had a femoral neck fracture 3 weeks postoperatively. At the last followup, the mean NAHS score increased by 29.1 points (54.8 ± 12 preoperatively to 83.9 ± 16 points at last followup). Eleven hips developed osteoarthritis and subsequently had total hip arthroplasty. The best results were obtained in patients younger than 40 years old with a 0 Tönnis grade. Refixation of the labrum did not correlate with a higher NAHS score (87 ± 11 with refixation versus 82 ± 19 points without) at the last followup. The technique for FAI treatment allowed direct visualization of the anterior femoral head-neck junction while avoiding surgical dislocation, had a low complication rate, and improved functional scores.

Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. CMC Paris V, 36 boulevard saint Marcel, 75005, Paris, France

    Frédéric Laude MD

  2. Hôpital la Pitié Salptrière, Paris, France

    Elhadi Sariali MD

  3. Institut Nollet, Paris, France

    Alexis Nogier MD

Authors
  1. Frédéric Laude MD
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  2. Elhadi Sariali MD
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  3. Alexis Nogier MD
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Corresponding author

Correspondence to Frédéric Laude MD.

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Each 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.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Laude, F., Sariali, E. & Nogier, A. Femoroacetabular Impingement Treatment Using Arthroscopy and Anterior Approach. Clin Orthop Relat Res 467, 747–752 (2009). https://doi.org/10.1007/s11999-008-0656-y

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  • DOI: https://doi.org/10.1007/s11999-008-0656-y

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