EFFECTIVENESS OF ARTHROSCOPE FOR FEMOROACETABULAR IMPINGEMENT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHAOLiang ,  WANGYijun , CAIDaozhang , ZENGChun , JINDadi

Orthopaedic Center, the Third Affiliated Hospital of Southern Medical University, Orthopaedic Institute in Guangdong Province, Guangzhou Guangdong, 510630, P. R. China;

Corresponding author：

WANGYijun, Email: wangyijun678@163.com

Keywords：

Femoroacetabular impingement; Arthroscopy; Minimally invasive technique

DOI：

10.7507/1002-1892.20160005

Video：

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Objective To investigate the early effectiveness of arthroscope for femoroacetabular impingement (FAI). Methods Between February 2012 and June 2014, 17 patients (17 hips) with FAI were treated under arthroscope. Of 17 patients, 12 were male and 5 were female, aged 18-60 years (mean, 37.2 years); 9 left hips and 8 right hips were involved. All patients had pain in groin for 12-24 months (mean, 15 months), no limited activity of the hip and obvious provocative pain in full flexion and internal rotation. The results of impingement test and the Faber test were all positive. According to X-ray examination, 8 cases were at early stage, 8 cases at middle stage, and 1 case at late stage; according to anatomical morphology, 6 cases were rated as cam-type impingement, 3 cases as pincer-type impingement, and 8 cases as mixed type. Based on impingement type, arthroscopic femoroplasty, arthroscopic acetabuloplasty, and a combination of arthroscopic femoroplasty and acetabuloplasty were performed on 6, 3, and 8 patients respectively. Results Primary healing of incision was obtained. One patient had numbness in the lateral thigh, and symptom disappeared after 2 weeks. All cases were followed up 1-2 years (mean, 1.3 years). All patients obtained obvious hip pain relief. The postoperative Harris scores were significantly increased to 91.44±1.98 at 6 weeks, 95.83±0.53 at 3 months, and 95.33±2.43 at 1 year from preoperative 79.01±3.20(P＜0.05), and the scores at 3 months and at 1 year were significantly higher than that at 6 weeks (P＜0.05), but there was no significant difference between at 3 months and at 1 year (P>0.05). Conclusion Arthroscope treatment of FAI can obviously relief hip pain. The key points for acquiring satisfactory early effectiveness are definite diagnosis, early detection, and minimally invasive treatment.

Citation： ZHAOLiang, WANGYijun, CAIDaozhang, ZENGChun, JINDadi. EFFECTIVENESS OF ARTHROSCOPE FOR FEMOROACETABULAR IMPINGEMENT. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(1): 21-24. doi: 10.7507/1002-1892.20160005 Copy

1.	Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement:a cause for osteoarthritis of the hip. Clin Orthop Relat Res, 2003, (417):112-120.
2.	Ganz R, Leunig M, Leunig-Ganz K, et al. The etiology of osteoarthritis of the hip:an integrated mechanical concept. Clin Orthop Relat Res, 2008, 466(2):264-272.
3.	Larson CM, Giveans MR. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy, 2009, 25(4):369-376.
4.	Philippon MJ, Briggs KK, Yen YM, et al. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction:Minimum two-year follow-up. J Bone Joint Surg (Br), 2009, 91(1):16-23.
5.	Philippon MJ, Weiss DR, Kuppersmith DA, et al. Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players. Am J Sports Med, 2010, 38(1):99-104.
6.	Byrd JW, Jones KS. Arthroscopic management of femoroacetabular impingement:minimum 2-year follow-up. Arthroscopy, 2011, 27(10):1379-1388.
7.	Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement:radiographic diagnosis——what the radiologist should know. AJR Am J Roentgenol, 2007, 188(6):1540-1552.
8.	Nepple JJ, Prather H, Trousdale RT, et al. Diagnostic imaging of femoroacetabular impingement. J Am Acad Orthop Surg, 2013, 21 Suppl 1:S20-S26.
9.	Kappe T, Kocak T, Bieger R, et al. Radiographic risk factors for labral lesions in femoroacetabular impingement. Clin Orthop Relat Res, 2011, 469(11):3241-3247.
10.	Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg (Br), 1999, 81(2):281-288.
11.	Tannast M, Kubiak-Langer M, Langlotz F, et al. Noninvasive three-dimensional assessment of femoroacetabular impingement. J Orthop Res, 2007, 25(1):122-131.
12.	Milone MT, Bedi A, Poultsides L, et al. Novel CT-based three-dimensional software improves the characterization of cam morphology. Clin Orthop Relat Res, 2013, 471(8):2484-2491.
13.	Krych AJ, Thompson M, Knutson Z, et al. Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement:a prospective randomized study. Arthroscopy, 2013, 29(1):46-53.
14.	Fiz N, Sánchez M, Pérez JC, et al. A less-invasive technique for capsular management during hip arthroscopy for femoroacetabular impingement. Arthrosc Tech, 2014, 3(4):e439-443.
15.	Leunig M, Ganz R. Relative neck lengthening and intracapital osteotomy for severe Perthes and Perthes-like deformities. Bull NYU Hosp Joint Dis, 2011, 69 Suppl 1:S62-S67.
16.	Zaltz I, Kelly BT, Larson CM, et al. Surgical treatment of femoroacetabular impingement:what are the limits of hip arthroscopy? Arthroscopy, 2014, 30(1):99-110.
17.	Larson CM, Giveans MR, Stone RM. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement:mean 3.5-year follow-up. Am J Sports Med, 2012, 40(5):1015-1021.
18.	Philippon MJ, Faucet SC, Briggs KK. Arthroscopic hip labral repair. Arthrosc Tech, 2013, 2(2):e73-76.

1. Ganz R, Parvizi J, Beck M, et al. Femoroacetabular impingement:a cause for osteoarthritis of the hip. Clin Orthop Relat Res, 2003, (417):112-120.
2. Ganz R, Leunig M, Leunig-Ganz K, et al. The etiology of osteoarthritis of the hip:an integrated mechanical concept. Clin Orthop Relat Res, 2008, 466(2):264-272.
3. Larson CM, Giveans MR. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement. Arthroscopy, 2009, 25(4):369-376.
4. Philippon MJ, Briggs KK, Yen YM, et al. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction:Minimum two-year follow-up. J Bone Joint Surg (Br), 2009, 91(1):16-23.
5. Philippon MJ, Weiss DR, Kuppersmith DA, et al. Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players. Am J Sports Med, 2010, 38(1):99-104.
6. Byrd JW, Jones KS. Arthroscopic management of femoroacetabular impingement:minimum 2-year follow-up. Arthroscopy, 2011, 27(10):1379-1388.
7. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement:radiographic diagnosis——what the radiologist should know. AJR Am J Roentgenol, 2007, 188(6):1540-1552.
8. Nepple JJ, Prather H, Trousdale RT, et al. Diagnostic imaging of femoroacetabular impingement. J Am Acad Orthop Surg, 2013, 21 Suppl 1:S20-S26.
9. Kappe T, Kocak T, Bieger R, et al. Radiographic risk factors for labral lesions in femoroacetabular impingement. Clin Orthop Relat Res, 2011, 469(11):3241-3247.
10. Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg (Br), 1999, 81(2):281-288.
11. Tannast M, Kubiak-Langer M, Langlotz F, et al. Noninvasive three-dimensional assessment of femoroacetabular impingement. J Orthop Res, 2007, 25(1):122-131.
12. Milone MT, Bedi A, Poultsides L, et al. Novel CT-based three-dimensional software improves the characterization of cam morphology. Clin Orthop Relat Res, 2013, 471(8):2484-2491.
13. Krych AJ, Thompson M, Knutson Z, et al. Arthroscopic labral repair versus selective labral debridement in female patients with femoroacetabular impingement:a prospective randomized study. Arthroscopy, 2013, 29(1):46-53.
14. Fiz N, Sánchez M, Pérez JC, et al. A less-invasive technique for capsular management during hip arthroscopy for femoroacetabular impingement. Arthrosc Tech, 2014, 3(4):e439-443.
15. Leunig M, Ganz R. Relative neck lengthening and intracapital osteotomy for severe Perthes and Perthes-like deformities. Bull NYU Hosp Joint Dis, 2011, 69 Suppl 1:S62-S67.
16. Zaltz I, Kelly BT, Larson CM, et al. Surgical treatment of femoroacetabular impingement:what are the limits of hip arthroscopy? Arthroscopy, 2014, 30(1):99-110.
17. Larson CM, Giveans MR, Stone RM. Arthroscopic debridement versus refixation of the acetabular labrum associated with femoroacetabular impingement:mean 3.5-year follow-up. Am J Sports Med, 2012, 40(5):1015-1021.
18. Philippon MJ, Faucet SC, Briggs KK. Arthroscopic hip labral repair. Arthrosc Tech, 2013, 2(2):e73-76.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF ARTHROSCOPE FOR FEMOROACETABULAR IMPINGEMENT

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