Mid-term effectiveness of arthroscopic surgery for femoroacetabular impingement_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 XIE Zongping , JIN Dongxu , SHEN Jiagen , ZHANG Changqing

Department of Orthopedics, the Sixth People’s Hospital of Shanghai, Affiliated to Shanghai Jiaotong University, Shanghai, 200233, P.R.China;

Corresponding author：

XIE Zongping, Email: x91034@qq.com

Keywords：

Femoroacetabular impingement; labral repair; acetabuloplasty; femoral neck osteoplasty; arthroscopy; mid-term effectiveness

DOI：

10.7507/1002-1892.201710046

Video：

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ObjectiveTo assess the mid-term effectiveness of arthroscopic surgery in treatment of femoroacetabular impingement (FAI).MethodsBetween July 2014 and December 2015, 131 patients (132 hips) with FAI were enrolled in this study. There were 68 males and 63 females with an average age of 42.5 years (range, 17-68 years). The FAI was located at left hip in 72 cases, right hip in 58 cases, and bilateral hips in 1 case. The mean disease duration was 35 months (range, 3-120 months). Under arthroscopy, the femoral neck osteoplasty and/or acetabular rim trimming were performed, then the torn labrum was repaired. At the same time, the iliopsoas tendon was divided and the torn round ligament was debrided. The effectiveness was assessed by the visual analogue scale (VAS) and the Harris hip score (HHS).ResultsAfter operation, the perineum nerve palsy and numbness of dorsal feet occurred in 2 cases and 3 cases, respectively. There was no other complication. All patients were followed up 20-36 months (mean, 27.7 months). There were significant differences in the VAS scores and HHS scores between pre-operation, post-operative 3 months, and the last follow-up (P<0.05). Imaging examination showed that joint interspace of the involved hip was normal, and there was no sign of impingement and osteoarthritis in the femoral neck or acetabulum.ConclusionArthroscopic labral repair and osteoplasty is an effective and safe management for FAI in the mid-term follow-up.

Citation： XIE Zongping, JIN Dongxu, SHEN Jiagen, ZHANG Changqing. Mid-term effectiveness of arthroscopic surgery for femoroacetabular impingement. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(2): 129-133. doi: 10.7507/1002-1892.201710046 Copy

1.	Smith-Petersen MN. The classic: Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. 1936. Clin Orthop Relat Res, 2009, 467(3): 608-615.
2.	Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement—A cause for osteoarthritis of the hip. Clin Orthop Relat Res, 2003, (417): 112-120.
3.	Nepple JJ, Clohisy JC. Evolution of femoroacetabular impingement treatment: the ANCHOR experience. Am J Orthop (Belle Mead N J), 2017, 46(1): 28-34.
4.	Khan M, Bedi A, Fu F, Karlsson J, et al. New perspectives on femoroacetabular impingement syndrome. Nat Rev Rheumatol, 2016, 12(5): 303-310.
5.	Hufeland M, Krüger D, Haas NP, et al. Arthroscopic treatment of femoroacetabular impingement shows persistent clinical improvement in the mid-term. Arch Orthop Trauma Surg, 2016, 136(5): 687-691.
6.	Philippon MJ, Briggs KK, Fagrelius T, et al. Labral refixation: current techniques and indications. HSS J, 2012, 8(3): 240-244.
7.	Larson CM, Giveans MR. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy, 2009, 25(4): 369-376.
8.	Ashberg L, Walsh JP, Yuen LC, et al. Outcomes of hip arthroscopy in adolescents: A comparison of acute versus chronic presentation. Two-year minimum follow-up. J Pediatr Orthop, 2017. [Epub ahead of print].
9.	Uchida S, Hatakeyama A, Kanezaki S, et al. Endoscopic shelf acetabuloplasty can improve clinical outcomes and achieve return to sports-related activity in active patients with hip dysplasia. Knee Surg Sports Traumatol Arthrosc, 2017. [Epub ahead of print].
10.	Uchida S, Wada T, Sakoda S, et al. Endoscopic shelf acetabuloplasty combined with labral repair, cam osteochondroplasty, and capsular plication for treating developmental hip dysplasia. Arthrosc Tech, 2014, 3(1): e185-191.
11.	Przybył M, Walenczak K, Lebiedziński R, et al. Analysis of arthroscopic therapy for hip pathologies. Ortop Traumatol Rehabil, 2017, 19(3): 249-261.
12.	Chen AW, Yuen LC, Ortiz-Declet V, et al. Selective debridement with labral preservation using narrow indications in the hip: minimum 5-year outcomes with a matched-pair labral repair control group. Am J Sports Med, 2017. [Epub ahead of print].
13.	Byrd JW, Jones KS. Arthroscopic management of femoroacetabular impingement: minimum 2-year follow-up. Arthroscopy, 2011, 27(10): 1379-1388.
14.	Matsuda DK, Gupta N, Hanami D. Hip arthroscopy for challenging deformities: global pincer femoroacetabular impingement. Arthrosc Tech, 2014, 3(2): e197-e204.
15.	Philippon MJ, Briggs KK, Yen YM, et al. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg (Br), 2009, 91(1): 16-23.
16.	Redmond JM, El Bitar YF, Gupta A, et al. Arthroscopic acetabuloplasty and labral refixation without labral detachment. Am J Sports Med, 2014, 43(1):105-112.
17.	Kollmorgen R, Mather R. Current concepts in labral repair and refixation: anatomical approach to labral management. Am J Orthop (Belle Mead NJ), 2017, 46(1): 42-48.
18.	Byrd JW, Jones KS. Primary repair of the acetabular labrum: outcomes with 2 years’ follow-up. Arthroscopy, 2014, 30(5): 588-592.

1. Smith-Petersen MN. The classic: Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. 1936. Clin Orthop Relat Res, 2009, 467(3): 608-615.
2. Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement—A cause for osteoarthritis of the hip. Clin Orthop Relat Res, 2003, (417): 112-120.
3. Nepple JJ, Clohisy JC. Evolution of femoroacetabular impingement treatment: the ANCHOR experience. Am J Orthop (Belle Mead N J), 2017, 46(1): 28-34.
4. Khan M, Bedi A, Fu F, Karlsson J, et al. New perspectives on femoroacetabular impingement syndrome. Nat Rev Rheumatol, 2016, 12(5): 303-310.
5. Hufeland M, Krüger D, Haas NP, et al. Arthroscopic treatment of femoroacetabular impingement shows persistent clinical improvement in the mid-term. Arch Orthop Trauma Surg, 2016, 136(5): 687-691.
6. Philippon MJ, Briggs KK, Fagrelius T, et al. Labral refixation: current techniques and indications. HSS J, 2012, 8(3): 240-244.
7. Larson CM, Giveans MR. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy, 2009, 25(4): 369-376.
8. Ashberg L, Walsh JP, Yuen LC, et al. Outcomes of hip arthroscopy in adolescents: A comparison of acute versus chronic presentation. Two-year minimum follow-up. J Pediatr Orthop, 2017. [Epub ahead of print].
9. Uchida S, Hatakeyama A, Kanezaki S, et al. Endoscopic shelf acetabuloplasty can improve clinical outcomes and achieve return to sports-related activity in active patients with hip dysplasia. Knee Surg Sports Traumatol Arthrosc, 2017. [Epub ahead of print].
10. Uchida S, Wada T, Sakoda S, et al. Endoscopic shelf acetabuloplasty combined with labral repair, cam osteochondroplasty, and capsular plication for treating developmental hip dysplasia. Arthrosc Tech, 2014, 3(1): e185-191.
11. Przybył M, Walenczak K, Lebiedziński R, et al. Analysis of arthroscopic therapy for hip pathologies. Ortop Traumatol Rehabil, 2017, 19(3): 249-261.
12. Chen AW, Yuen LC, Ortiz-Declet V, et al. Selective debridement with labral preservation using narrow indications in the hip: minimum 5-year outcomes with a matched-pair labral repair control group. Am J Sports Med, 2017. [Epub ahead of print].
13. Byrd JW, Jones KS. Arthroscopic management of femoroacetabular impingement: minimum 2-year follow-up. Arthroscopy, 2011, 27(10): 1379-1388.
14. Matsuda DK, Gupta N, Hanami D. Hip arthroscopy for challenging deformities: global pincer femoroacetabular impingement. Arthrosc Tech, 2014, 3(2): e197-e204.
15. Philippon MJ, Briggs KK, Yen YM, et al. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg (Br), 2009, 91(1): 16-23.
16. Redmond JM, El Bitar YF, Gupta A, et al. Arthroscopic acetabuloplasty and labral refixation without labral detachment. Am J Sports Med, 2014, 43(1):105-112.
17. Kollmorgen R, Mather R. Current concepts in labral repair and refixation: anatomical approach to labral management. Am J Orthop (Belle Mead NJ), 2017, 46(1): 42-48.
18. Byrd JW, Jones KS. Primary repair of the acetabular labrum: outcomes with 2 years’ follow-up. Arthroscopy, 2014, 30(5): 588-592.

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