Arthroscopic versus open cam resection in the treatment of femoroacetabular impingement

Büchler, Lorenz; Neumann, Mirjam; Schwab, Joseph M; Iselin, Lukas; Tannast, Moritz; Beck, Martin (2013). Arthroscopic versus open cam resection in the treatment of femoroacetabular impingement. Arthroscopy - the journal of arthroscopic & related surgery, 29(4), pp. 653-60. Elsevier 10.1016/j.arthro.2012.12.009

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PURPOSE

The purpose of this study was to evaluate if osseous correction of the femoral neck achieved arthroscopically is comparable to that achieved by surgical dislocation.

METHODS

We retrospectively analyzed all patients who were treated with hip arthroscopy or surgical dislocation for cam or mixed type femoroacetabular impingement (FAI) in our institution between 2006 and 2009. Inclusion criteria were complete clinical and radiologic documentation with standardized radiographs. Group 1 consisted of 66 patients (49 female patients, mean age 33.8 years) treated with hip arthroscopy. Group 2 consisted of 135 patients (91 male patients, mean age 31.2 years) treated with surgical hip dislocation. We compared the preoperative and postoperative alpha and gamma angles, as well as the triangular index. Mean follow-up was 16.7 months (range, 2 to 79 months).

RESULTS

In group 1, the mean alpha angle improved from 60.7° preoperatively to 47.8° postoperatively (P < .001) and the mean gamma angle improved from 47.3° to 44.5° (P < .001). Over time, the preoperative mean alpha angle increased from 56.3° in 2006 to 67.5° in 2009, whereas the postoperative mean alpha angle decreased from 51.2° in 2006 to 47.5° in 2009. In group 2, the mean alpha angle improved from 75.3° preoperatively to 44.8° postoperatively (P < .001), and the mean gamma angle improved from 65.1° to 52.2° (P < .001). Arthroscopic revision of intra-articular adhesions was performed in 4 patients (6.1%) in group 1 and 16 patients (12%) in group 2. Three patients (2.2%) in group 2 underwent revision for nonunion of the greater trochanter.

CONCLUSIONS

Osseous correction of cam-type FAI with hip arthroscopy is comparable to the correction achieved by surgical hip dislocation. There is a significant learning curve for hip arthroscopy, with postoperative osseous correction showing improved results with increasing surgical experience.

LEVEL OF EVIDENCE

Level III, retrospective comparative 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:	Büchler, Lorenz, Tannast, Moritz
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0749-8063
Publisher:	Elsevier
Language:	English
Submitter:	Stephanie Schmutz
Date Deposited:	25 Feb 2014 11:40
Last Modified:	05 Dec 2022 14:28
Publisher DOI:	10.1016/j.arthro.2012.12.009
PubMed ID:	23395249
URI:	https://boris.unibe.ch/id/eprint/42338