ASSESSMENT OF ARTHROSCOPIC TREATMENT OF THE HIP WITH FEMOROACETABULAR IMPINGEMENT: A PROSPECTIVE MULTICENTRE STUDY.

Orthop Traumatol Surg Res, Dec 2010
Gedouin JE, May O, Bonin N, Nogier A, Boyer T, Sadri H, Villar RN, Laude F
Surgical treatment of femoroacetabular impingement can be carried out by hip arthroscopy, so as to limit the morbidity of an open operation. With considerable encouragement from recent good results, hip arthroscopy is replacing the alternative techniques for this indication. The authors' hypothesis was that hip arthroscopy makes it possible to correct the femoroacetabular impingement lesion with a low rate of morbidity. The aim of the study was to assess the indications, the quality of the technique and its effect on early results, as well as its complications. The study included 111 hips and 110 patients (78 men, 32 women, mean age 31 years) who underwent hip arthroscopy for femoroacetabular impingement by six surgeons. In 65 patients no radiographic signs of arthritis were found, while in 36 grade 1 osteoarthritic changes were found radiographically, according to the Tonnis scale.
The mean WOMAC score rose from 60.3 points preoperatively to 83 (p<0.001) over a mean period of 10 months. 77% of patients were satisfied or very satisfied with the result of the operation. Patients with early osteoarthritis had a lower WOMAC score and a lower satisfaction score than those without osteoarthritis. Five patients underwent total hip arthroplasty or resurfacing arthroplasty. There were seven complications: three of heterotopic ossification, two of neurapraxia, one of necrosis of a labium majus, and one undisplaced fracture of the femoral neck.
The results confirmed the effectiveness and the low morbidity of hip arthroscopy in the management of femoroacetabular impingement syndrome. The medium-term results were comparable with those in the literature. The presence of osteoarthritis on radiographs is associated with poorer results, and this approach should therefore not be indicated in cases with osteoarthritis of more than grade 1.