Arthroscopic treatment of femoroacetabular impingement in adolescents

The aim of this very recent study, published in the American journal “Arthroscopy” in the May 2016 issue, was to report the results of hip arthroscopy in adolescent patients with symptomatic femoroacetabular impingement compared with a control group of adult patients who were also treated arthroscopically for femoroacetabular impingement.
All patients who underwent hip arthroscopy were assessed with the modified Harris Hip Score before surgery and postoperatively at 3, 12, 24 and 60 months. The inclusion criteria were that all patients should be under 18 years of age and should also have been followed up for at least one year postoperatively. All of these cases were collected over a period of eight years.
The study group consisted of 122 consecutive hips (108 patients) and the control group of 122 hips. The mean follow-up was 30 months. For the study group the mean age was 16 years, with 55 males and 65 females. The control group had a mean age of 36 years, with 71 males and 51 females. In the study group, the mean scores were 68.3 preoperatively and 93.6 postoperatively, an improvement of 25.4 points. The mean duration of symptoms was 16.6 months and 95.9% took part in sporting activities. The study group comprised 36 patients with a cam-type femoroacetabular impingement lesion, 17 with a pincer type and 69 with mixed lesions. Of 111 tears of the acetabular labrum, 85 were treated by repair and 26 by partial resection and debridement. There were 101 acetabular cartilage lesions, 4 microfractures and 3 cartilage lesions of the femoral head.
In the control group the mean scores were 63.3 preoperatively and 85.5 postoperatively, an improvement of 22.2 points. The mean duration of symptoms was 31.2 months and 61.5% took part in sporting activities. The control group comprised 53 cam-type femoroacetabular impingement lesions, 5 pincer type and 64 mixed. Of 103 tears of the acetabular labrum, 52 repairs and 51 partial resections and debridements were performed. There were 112 acetabular cartilage lesions, 20 microfractures and 17 cases with cartilage lesions of the femoral head. The study group included 15 extra-articular procedures carried out at the same time, while there were 5 in the control group. In the study group 4 patients underwent revision hip arthroscopy and 1 a periacetabular osteotomy. In the control group 1 patient underwent revision hip arthroscopy.
The authors of this article concluded that the results of hip arthroscopy for femoroacetabular impingement in adolescents are just as good as those in adults. The present data also support the view that hip arthroscopy plays an important role in the treatment of femoroacetabular impingement syndrome in adolescents.
Source: “Arthroscopy”, 2016