Surgical hip dislocation versus hip arthroscopy for femoroacetabular impingement: clinical and morphological short-term results

Introduction Femoroacetabular impingement (FAI) resulting from abnormal contact between the acetabulum and femur has been studied extensively in recent years owing to its association with acetabular labrum tears and possible contribution to the development of osteoarthritis. Methods A comprehensive PubMed, MEDLINE® and Embase™ literature search was conducted. Search terms included ‘femoroacetabular impingement’, ‘pathophysiology’, ‘diagnosis’, ‘dGEMRIC’, ‘arthroscopic’, ‘open’, ‘mini-open’ and ‘outcome measure’. Results A range of radiographic features have been described, and computed tomography and magnetic resonance imaging are both commonly used in the diagnosis of the bony abnormalities in FAI. Treatment of FAI is surgical with methods of treatment ranging from open surgical hip dislocation to arthroscopic osteochondroplasty. Conclusions In recent years, a trend towards the use of arthroscopic treatment for FAI has been seen, with promising results from a range of studies. However, only short-term outcome data are available and a range of different outcome measures have been used in studies to date. We present an overview of the outcomes for a range of surgical treatment methods for FAI and discuss the outcome measures used.

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Surgical treatment of symptomatic post-slipped capital femoral epiphysis deformity: a comparative study between hip arthroscopy and surgical hip dislocation with or without intertrochanteric osteotomy

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.14.190194 ◽

2020 ◽

Vol 14 (2) ◽

pp. 98-105 ◽

Cited By ~ 2

Author(s):

James D. Wylie ◽

Michael P. McClincy ◽

Nishant Uppal ◽

Patricia E. Miller ◽

Young-Jo Kim ◽

...

Keyword(s):

Surgical Treatment ◽

Hip Arthroscopy ◽

Research Question ◽

Slipped Capital Femoral Epiphysis ◽

Hip Dislocation ◽

Cartilage Defects ◽

Surgical Hip Dislocation ◽

Level Of Evidence ◽

Articular Damage ◽

Before And After

Purpose Our primary research question was to investigate the severity of deformity and articular damage as well as outcomes in patients undergoing hip arthroscopy compared with open surgery for the treatment of symptomatic slipped capital femoral epiphysis (SCFE) deformity. Methods Retrospective review of surgical treatment of symptomatic SCFE deformity with a minimum one-year follow-up. Patients were divided into three groups: the arthroscopic group, surgical hip dislocation(SHD) group and SHD with femoral osteotomy (SHD+ITO) group. Deformity severity was quantified. Hip outcome was assessed by the modified Merle d’Aubigné Postel (MDP) scores. Results There were more severe slips treated by SHD and SHD+ITO. There was more severe deformity in the SHD+ITO group than the arthroscopy group (p < 0.001). There were more full thickness acetabular cartilage defects in the SHD and the SHD+ITO groups (> 40%) compared with the arthroscopy group (11%; p = 0.03). The SHD+ITO and SHD group had lower MDP scores compared with the arthroscopy group both before and after surgery but no difference was detected in the amount of improvement from surgery across groups (p > 0.05). Moderate and severe SCFEs had worse preoperative scores but improvement was not different compared with mild SCFEs (p > 0.05). Conclusion Patients undergoing open treatment had more severe SCFE deformity with more extensive articular damage at reconstructive surgery compared with patients undergoing arthroscopy. All groups with SCFE deformity had improved pain and hip function postoperatively. Level of Evidence III

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