Surgical hip dislocation is more powerful than arthroscopy for achieving high degrees of acetabular correction in pincer type impingement.

Ahmad, Sufian S.; Heilgemeir, Maximilian; Anwander, Helen; Beck, Martin (2019). Surgical hip dislocation is more powerful than arthroscopy for achieving high degrees of acetabular correction in pincer type impingement. Orthopaedics & traumatology, surgery & research, 105(7), pp. 1339-1344. Elsevier 10.1016/j.otsr.2019.08.009

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BACKGROUND With the development of hip arthroscopy (HA), a shift away from surgical hip dislocation (SHD) is becoming a noticeable reality. It was the aim of this study to examine whether SHD provides a benefit over HA regarding its corrective power in the treatment of femoroacetabular impingement (FAI). HYPOTHESIS It was hypothesized that SHD provides the more powerful tool for acetabular correction in FAI surgery compared to HA. METHOD The examined cohort consisted of 85 hips of which 31 (36%) underwent a high degree of acetabular correction which was defined as a correction of >2 standard deviations from the population mean. A lateral center edge angle (LCE) correction>12° or an acetabular index (AI) correction>8° were therefore considered to high correction. A logistic regression model was applied to determine factors influencing high correction in FAI surgery. Subsequent adjustment was performed using a multivariate model. RESULTS After adjusting for pre-operative acetabular orientation, SHD showed a pronounced influence on the likelihood of achieving the adequate degree of high acetabular correction (odds ratio (OR) 10.0 confidence interval (C.I) 2.3 to 44.0, p=0.002). On the other hand, SHD showed no influence on femoral correction (p=n.s). CONCLUSION Surgical hip dislocation is a powerful modality for achieving high degrees of acetabular correction in the situation of a femoroactabular conflict, being defined as an LCE correction of>12° or AI correction of>8°. The reason for these results may be seen in the excellent exposure and the improved possibility of performing dynamic intra-operative examination to verify the results. The benefits are only limited to large acetabular correction. These findings should provide a helpful tool for decision making in clinical practise. LEVEL OF EVIDENCE Level III retrospective cohort study.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Anwander, Helen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1877-0568

Publisher:

Elsevier

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

25 Oct 2019 14:44

Last Modified:

12 Nov 2019 01:32

Publisher DOI:

10.1016/j.otsr.2019.08.009

PubMed ID:

31564633

Uncontrolled Keywords:

Conflict FAI Femoroacetabular impingement Hip arthroscopy Impingement Surgical hip dislocation

BORIS DOI:

10.7892/boris.134166

URI:

https://boris.unibe.ch/id/eprint/134166

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