[Treatment of FAI Via a Minimally Invasive Ventral Approach with Arthroscopic Assistance. Technique and Midterm Results]

Overview

Journal Orthopade

Specialty Orthopedics

Date 2009 May 6

PMID 19415236

Citations 10

Authors

F Laude

E Sariali

Affiliations

Soon will be listed here.

Abstract

Femoroacetabular impingement (FAI) may be considered as an important cause of hip pain among young patients. A new surgical technique using a mini open anterior Hueter approach with arthroscopic assistance was developed in our department in 1999. The goal of our study was to evaluate the midterm clinical results and the quality of life after cam resection, rim trimming, and labrum refixation using this technique. The first 100 hips operated on using this technique were evaluated with the Nonarthritic Hip Score (NAHS) at a mean follow-up of 54 months. The mean age of the patients was 33.4 years, with 50 men and 47 women. At the last follow-up, the mean NAHS score increased significantly from 54.5+/-12 by 29.6 points to 84.3+/-16 (p<0.001). The clinical result was very good in 40 cases, good in 38 cases, fair in 8 cases, and poor in 14 patients. Eleven hips developed osteoarthrosis and finally had a total hip replacement. One patient had a femoral neck fracture at 3 weeks postoperatively. The best results were obtained in patients under 40 years of age (53 patients) and with a Tönnis osteoarthrosis grade of 0, 90% of whom had a very good or good result at a mean follow-up of 55 months. Refixation of the labrum was not significantly correlated with a higher NAHS (87+/-11 versus 82+/-19, p=0.13) at the last follow-up. Resection of cam FAI of the femoral head-neck junction using a mini anterior Hueter approach with arthroscopic assistance is a safe and effective technique in treating young adults with femoroacetabular impingement. This technique offers direct visualization of the anterior femoral head-neck junction and is less invasive than the surgical dislocation approach.

Citing Articles

Outcomes After Management of Subspine and Femoroacetabular Impingement Using a Direct Anterior Mini-Open Approach.

Xu L, Chen K, Peng J, Zhu J, Shen C, Chen X Orthop J Sports Med. 2021; 9(12):23259671211055723.

PMID: 34901289 PMC: 8655457. DOI: 10.1177/23259671211055723.

Functional outcome and complication following THA through modified direct anterior approach correlated to cadaveric study: are there any differences in Asian hip?.

Phruetthiphat O, Sangthumprateep V, Trakulngernthai S, Aegakkatajit N, Chotanaphuti T, Chanpoo M J Orthop Surg Res. 2021; 16(1):513.

PMID: 34416884 PMC: 8377820. DOI: 10.1186/s13018-021-02661-6.

Periacetabular Osteotomy Provides Higher Survivorship Than Rim Trimming for Acetabular Retroversion.

Zurmuhle C, Anwander H, Albers C, Hanke M, Steppacher S, Siebenrock K Clin Orthop Relat Res. 2016; 475(4):1138-1150.

PMID: 27921206 PMC: 5339145. DOI: 10.1007/s11999-016-5177-5.

Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection.

Anwander H, Siebenrock K, Tannast M, Steppacher S Clin Orthop Relat Res. 2016; 475(4):1178-1188.

PMID: 27744594 PMC: 5339132. DOI: 10.1007/s11999-016-5114-7.

[Resection at symptomatic cam impingement. Use of a minimally invasive antero-lateral approach].

Weihs J, Scacchi P, Hess R, Albers C Orthopade. 2015; 45(4):349-54.

PMID: 26472111 DOI: 10.1007/s00132-015-3180-2.

References

Christensen C, Althausen P, Mittleman M, Lee J, McCarthy J . The nonarthritic hip score: reliable and validated. Clin Orthop Relat Res. 2003; (406):75-83. DOI: 10.1097/01.blo.0000043047.84315.4b. View

Murphy S, Tannast M, Kim Y, Buly R, Millis M . Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results. Clin Orthop Relat Res. 2004; (429):178-81. DOI: 10.1097/01.blo.0000150307.75238.b9. View

Laude F, Boyer T, Nogier A . Anterior femoroacetabular impingement. Joint Bone Spine. 2007; 74(2):127-32. DOI: 10.1016/j.jbspin.2007.01.001. View

Byrd J, Pappas J, Pedley M . Hip arthroscopy: an anatomic study of portal placement and relationship to the extra-articular structures. Arthroscopy. 1995; 11(4):418-23. DOI: 10.1016/0749-8063(95)90193-0. View

Crawford J, Villar R . Current concepts in the management of femoroacetabular impingement. J Bone Joint Surg Br. 2005; 87(11):1459-62. DOI: 10.1302/0301-620X.87B11.16821. View

May O, Matar W, Beaule P . Treatment of failed arthroscopic acetabular labral debridement by femoral chondro-osteoplasty: a case series of five patients. J Bone Joint Surg Br. 2007; 89(5):595-8. DOI: 10.1302/0301-620X.89B5.18753. View

Clohisy J, McClure J . Treatment of anterior femoroacetabular impingement with combined hip arthroscopy and limited anterior decompression. Iowa Orthop J. 2005; 25:164-71. PMC: 1888771. View

Mardones R, Gonzalez C, Chen Q, Zobitz M, Kaufman K, Trousdale R . Surgical treatment of femoroacetabular impingement: evaluation of the effect of the size of the resection. J Bone Joint Surg Am. 2005; 87(2):273-9. DOI: 10.2106/JBJS.D.01793. View

Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock K . Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003; (417):112-20. DOI: 10.1097/01.blo.0000096804.78689.c2. View

10.

Beck M, Kalhor M, Leunig M, Ganz R . Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005; 87(7):1012-8. DOI: 10.1302/0301-620X.87B7.15203. View

11.

P Zebala L, Schoenecker P, Clohisy J . Anterior femoroacetabular impingement: a diverse disease with evolving treatment options. Iowa Orthop J. 2007; 27:71-81. PMC: 2150646. View

12.

Sariali E, Leonard P, Mamoudy P . Dislocation after total hip arthroplasty using Hueter anterior approach. J Arthroplasty. 2008; 23(2):266-72. DOI: 10.1016/j.arth.2007.04.003. View

13.

Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R . Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004; (418):67-73. View

14.

Espinosa N, Rothenfluh D, Beck M, Ganz R, Leunig M . Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am. 2006; 88(5):925-35. DOI: 10.2106/JBJS.E.00290. View

15.

Espinosa N, Beck M, Rothenfluh D, Ganz R, Leunig M . Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am. 2007; 89 Suppl 2 Pt.1:36-53. DOI: 10.2106/JBJS.F.01123. View

16.

Beaule P, Le Duff M, Zaragoza E . Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am. 2007; 89(4):773-9. DOI: 10.2106/JBJS.F.00681. View

17.

Parvizi J, Leunig M, Ganz R . Femoroacetabular impingement. J Am Acad Orthop Surg. 2007; 15(9):561-70. DOI: 10.5435/00124635-200709000-00006. View

18.

Leunig M, Ganz R . [Femoroacetabular impingement. A common cause of hip complaints leading to arthrosis]. Unfallchirurg. 2004; 108(1):9-10, 12-7. DOI: 10.1007/s00113-004-0902-z. View

19.

Stucki G, Sangha O, Stucki S, Michel B, Tyndall A, Dick W . Comparison of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index and a self-report format of the self-administered Lequesne-Algofunctional index in patients with knee and hip osteoarthritis. Osteoarthritis Cartilage. 1998; 6(2):79-86. DOI: 10.1053/joca.1997.0097. View

20.

Leunig M, Beck M, Dora C, Ganz R . [Femoroacetabular impingement: trigger for the development of coxarthrosis]. Orthopade. 2005; 35(1):77-84. DOI: 10.1007/s00132-005-0896-4. View