Open Versus Arthroscopic Approach in the Treatment of Femoroacetabular Impingement: a Case-control Study with Two-years Follow Up

Overview

Journal Rev Bras Ortop

Specialty Orthopedics

Date 2017 Oct 4

PMID 28971082

Citations 7

Authors

Bruno Dutra Roos

Milton Valdomiro Roos

Antero Camisa Junior

Ezequiel Moreno Ungaretti Lima

Mauricio Domingos Betto

Affiliations

Soon will be listed here.

Abstract

Objective: To compare clinical and imaging results and complications between patients treated for femoroacetabular impingement (FAI) who underwent either anterior open surgery or an arthroscopic approach, with a minimum follow-up of two years.

Methods: This retrospective case-control study included patients submitted to FAI surgical treatment between November 2007 and March 2012. Patients treated with open surgery were compared with those treated with arthroscopy. Patients were clinically assessed by the modified Harris Hip Score, Non-Arthritic Hip Score, and internal hip rotation. Patients were radiographically assessed by the center-edge angle, joint space width, alpha angle, neck-head index, degree of arthrosis, and presence of heterotopic ossification of the hip.

Results: In the study period, 56 patients (58 hips) with FAI were included; 16 underwent open surgery and 40 underwent arthroscopy. The 40 patients treated by the arthroscopic route had a mean follow-up of 29.1 months, and 75.6% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. The 16 patients who underwent open surgery had a mean follow-up of 52 months, and 70.58% presented good or excellent clinical results. The radiographic evaluation parameters progressed to normal levels. Postoperative clinical and radiographic results were considered similar in both groups.

Conclusions: Arthroscopy and open surgery treatments for FAI provided comparable clinical and radiographic results. However, a higher rate of complications was observed in the open surgery group.

Citing Articles

Heterotopic Ossification After Arthroscopic Procedures: A Scoping Review of the Literature.

Zhou L, Gee S, Hansen J, Posner M Orthop J Sports Med. 2022; 10(1):23259671211060040.

PMID: 35071654 PMC: 8777353. DOI: 10.1177/23259671211060040.

There is no definite consensus on the adequate radiographic correction in arthroscopic osteochondroplasty for femoroacetabular impingement: a systematic review and meta-analysis.

Cohen D, Khan A, Kay J, Slawaska-Eng D, Almasri M, Simunovic N Knee Surg Sports Traumatol Arthrosc. 2021; 29(9):2799-2818.

PMID: 34173836 DOI: 10.1007/s00167-021-06645-1.

Revision Surgery and Progression to Total Hip Arthroplasty After Surgical Correction of Femoroacetabular Impingement: A Systematic Review.

Migliorini F, Maffulli N, Baroncini A, Eschweiler J, Tingart M, Betsch M Am J Sports Med. 2021; 50(4):1146-1156.

PMID: 34081552 PMC: 8980457. DOI: 10.1177/03635465211011744.

Evaluation of outcome reporting trends for femoroacetabular impingement syndrome- a systematic review.

Lindman I, Nikou S, Ohlin A, Hamrin Senorski E, Ayeni O, Karlsson J J Exp Orthop. 2021; 8(1):33.

PMID: 33893563 PMC: 8065071. DOI: 10.1186/s40634-021-00351-0.

Arthroscopic versus open treatment for femoroacetabular impingement: A systematic review and meta-analyses.

Qiao H, Zhang Y, Ren Y, Tian M Medicine (Baltimore). 2020; 99(47):e23364.

PMID: 33217880 PMC: 7676599. DOI: 10.1097/MD.0000000000023364.

References

Clohisy J, Carlisle J, Beaule P, Kim Y, Trousdale R, Sierra R . A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am. 2008; 90 Suppl 4:47-66. PMC: 2682767. DOI: 10.2106/JBJS.H.00756. View

Botser I, Smith Jr T, Nasser R, Domb B . Open surgical dislocation versus arthroscopy for femoroacetabular impingement: a comparison of clinical outcomes. Arthroscopy. 2011; 27(2):270-8. DOI: 10.1016/j.arthro.2010.11.008. View

Smith-Petersen M . The classic: Treatment of malum coxae senilis, old slipped upper femoral epiphysis, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. 1936. Clin Orthop Relat Res. 2008; 467(3):608-15. PMC: 2635442. DOI: 10.1007/s11999-008-0670-0. View

Fitzgerald Jr R . Acetabular labrum tears. Diagnosis and treatment. Clin Orthop Relat Res. 1995; (311):60-8. View

Ganz R, Gill T, Gautier E, GANZ K, Krugel N, Berlemann U . Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2002; 83(8):1119-24. DOI: 10.1302/0301-620x.83b8.11964. View

Guanche C, Bare A . Arthroscopic treatment of femoroacetabular impingement. Arthroscopy. 2006; 22(1):95-106. DOI: 10.1016/j.arthro.2005.10.018. View

Brooker A, Bowerman J, Robinson R, RILEY Jr L . Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973; 55(8):1629-32. View

Byrd J, Jones K . Arthroscopic management of femoroacetabular impingement: minimum 2-year follow-up. Arthroscopy. 2011; 27(10):1379-88. DOI: 10.1016/j.arthro.2011.05.018. View

Laude F, Sariali E, Nogier A . Femoroacetabular impingement treatment using arthroscopy and anterior approach. Clin Orthop Relat Res. 2008; 467(3):747-52. PMC: 2635440. DOI: 10.1007/s11999-008-0656-y. View

10.

Matsuda D, Carlisle J, Arthurs S, Wierks C, Philippon M . Comparative systematic review of the open dislocation, mini-open, and arthroscopic surgeries for femoroacetabular impingement. Arthroscopy. 2011; 27(2):252-69. DOI: 10.1016/j.arthro.2010.09.011. View

11.

Roos B, Roos M, Camisa Junior A, Lima E, Gyboski D, Martins L . Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications. Rev Bras Ortop. 2015; 50(4):430-7. PMC: 4563045. DOI: 10.1016/j.rboe.2015.06.011. View

12.

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

13.

Srinivasan S, Hosny H, Williams M . Combined hip arthroscopy and limited open osteochondroplasty for anterior femoroacetabular impingement: early patient reported outcomes. Hip Int. 2013; 23(2):218-24. DOI: 10.5301/HIP.2013.10728. View

14.

Ito K, Minka 2nd M, Leunig M, Werlen S, Ganz R . Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001; 83(2):171-6. DOI: 10.1302/0301-620x.83b2.11092. View

15.

Ribas M, Marin-Pena O, Regenbrecht B, de la Torre B, Vilarrubias J . Hip osteoplasty by an anterior minimally invasive approach for active patients with femoroacetabular impingement. Hip Int. 2009; 17(2):91-8. DOI: 10.1177/112070000701700207. View

16.

Horisberger M, Brunner A, Herzog R . Arthroscopic treatment of femoroacetabular impingement of the hip: a new technique to access the joint. Clin Orthop Relat Res. 2009; 468(1):182-90. PMC: 2795806. DOI: 10.1007/s11999-009-1005-5. View

17.

Seldes R, Tan V, Hunt J, Katz M, Winiarsky R, Fitzgerald Jr R . Anatomy, histologic features, and vascularity of the adult acetabular labrum. Clin Orthop Relat Res. 2001; (382):232-40. DOI: 10.1097/00003086-200101000-00031. View

18.

Meyer D, Beck M, Ellis T, Ganz R, Leunig M . Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res. 2006; 445:181-5. DOI: 10.1097/01.blo.0000201168.72388.24. View

19.

Philippon M, Briggs K, Yen Y, Kuppersmith D . Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br. 2008; 91(1):16-23. DOI: 10.1302/0301-620X.91B1.21329. View

20.

Domb B, Stake C, Botser I, Jackson T . Surgical dislocation of the hip versus arthroscopic treatment of femoroacetabular impingement: a prospective matched-pair study with average 2-year follow-up. Arthroscopy. 2013; 29(9):1506-13. DOI: 10.1016/j.arthro.2013.06.010. View