Purpose: The purpose of this study was to evaluate the early outcomes of arthroscopic management
of femoroacetabular impingement (FAI). Methods: Ninety-six consecutive patients (100 hips) with radiographically documented FAI were
treated with hip arthroscopy, labral debridement or repair/refixation, proximal femoral
osteoplasty, or acetabular rim trimming (or some combination thereof). Outcomes were
measured with the impingement test, modified Harris Hip Score, Short Form 12, and
pain score on a visual analog scale preoperatively and postoperatively at 6 weeks,
3 months, and 6 months, as well as yearly thereafter. Preoperative and postoperative
radiographic α angles were measured to evaluate the adequacy of proximal femoral osteoplasty.
Results: There were 54 male and 42 female patients with up to 3 years' follow-up (mean, 9.9
months). The mean age was 34.7 years. Isolated cam impingement was identified in 17
hips, pincer impingement was found in 28, and both types were noted in 55. Thirty
hips underwent labral repair/refixation. A comparison of preoperative scores with
those obtained at most recent follow-up revealed a significant improvement (P < .001) for all outcomes measured: Harris Hip Score (60.8 v 82.7), Short Form 12 (60.2 v 77.7), visual analog score for pain (6.74 v 1.88 cm), and positive impingement test (100% v 14%). The α angle was also significantly improved after resection osteoplasty. Complications
included heterotopic bone formation (6 hips) and a 24-hour partial sciatic nerve neurapraxia
(1 hip). No hip went on to undergo repeat arthroscopy, and three hips have subsequently
undergone total hip arthroplasty. Conclusions: Arthroscopic management of patients with FAI results in significant improvement in
outcomes measures, with good to excellent results being observed in 75% of hips at
a minimum 1-year follow-up. Alteration in the natural progression to osteoarthritis
and sustained pain relief as a result of arthroscopic management of FAI remain to
be seen. Level of Evidence: Level IV, therapeutic case series.
Key Words
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Article info
Publication history
Published online: January 21, 2008
Footnotes
Supported by research grants from Omeros, Seattle, WA; Biomet, Warsaw, IN; and Smith & Nephew, Andover, MA.
Identification
Copyright
© 2008 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
