Femoroacetabular impingement is a recognized etiology of intra-articular pathology and subsequent osteoarthritis in young adults. Arthroscopy has been useful in the management of hip pathology and has been proposed as a method of correcting the underlying impingement. The purpose of this study is to report the results of our early experience in the arthroscopic management of femoroacetabular impingement with two year follow up.
All patients undergoing hip arthroscopy are prospectively assessed with a modified Harris hip score at 3, 12, 24, 60 and 120 months. 752 patients have undergone arthroscopic correction of FAI. This report consists of a cohort of the first 100 such patients with two-year follow up.
There was 100% follow up at two years. The average age was 34 years (range 13-76 years) with 67 males and 33 females. There were 63 cam, 18 pincer and 19 combined lesions. Among cam types, the average age was 33 years with a male/female ratio of 2.8:1 and among pincer types, the average age was 38 years with a male/female ratio of 1.2:1. There were 97 acetabular articular lesions (53 Grade IV, 39 Grade III, 5 Grade I), 23 femoral lesions (11 Grade IV, 11 Grade III, 1 Grade II) and 92 labral tears. The median improvement was 20 points (preop 65; postop 85) with 79 good and excellent results. Those with associated femoral lesions did at least as well with median 23-point improvement. Eighteen patients underwent microfracture with a median improvement of 21 points (preop 64; postop 85). None required conversion to total hip arthroplasty, but six underwent a subsequent arthroscopic procedure. There were three complications with a transient neuropraxia of the pudendal nerve and the lateral femoral cutaneous nerve, each of which resolved uneventfully, and one mild case of heterotopic ossification.
Arthroscopic management of femoroacetabular impingement appears to be an appropriate option for many cases. These results are at least comparable to published reports of open methods with the advantages of a less invasive approach.
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.