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Arthroscopically assisted anterior decompression for femoroacetabular impingement: technique and early clinical results.
Archives of Orthopaedic and Trauma Surgery 2009 August
INTRODUCTION: In patients with symptomatic femoroacetabular impingement resection osteochondroplasty of the femoral head-neck junction may improve hip pain and range of motion. We evaluated the short-term treatment results of an arthroscopically assisted mini-open anterior approach to compare it with the results after surgical dislocation for FAI.
METHODS: The clinical and radiographic results of 33 patients were reviewed retrospectively 15 months after the surgery. Harris hip scores and plain radiographs were obtained preoperatively and at follow-up. Patient satisfaction with the treatment result was quantified with a Visual Analogous scale (VAS) ranging from 0 (very dissatisfied) to 10 (very satisfied).
RESULTS: The mean Harris hip score improved from 64 points preoperatively to 85 points at the time of follow-up (P < 0.001). Mean patient satisfaction on the VAS was seven points (range: 2-10 points). In two of our first patients we observed a transient femoral nerve palsy (completely resolved at follow-up) and 15 patients reported numbness in the area of the lateral cutaneous femoral nerve.
CONCLUSIONS: Treatment of anterior femoroacetabular impingement through an arthroscopically assisted mini-open anterior approach can reduce pain and improve function in a short-term observation period. Femoral osteochondroplasty as well as surgical treatment of acetabular cartilage and labrum lesions are possible, but the access is limited to the anterior and anterolateral part of the hip joint.
METHODS: The clinical and radiographic results of 33 patients were reviewed retrospectively 15 months after the surgery. Harris hip scores and plain radiographs were obtained preoperatively and at follow-up. Patient satisfaction with the treatment result was quantified with a Visual Analogous scale (VAS) ranging from 0 (very dissatisfied) to 10 (very satisfied).
RESULTS: The mean Harris hip score improved from 64 points preoperatively to 85 points at the time of follow-up (P < 0.001). Mean patient satisfaction on the VAS was seven points (range: 2-10 points). In two of our first patients we observed a transient femoral nerve palsy (completely resolved at follow-up) and 15 patients reported numbness in the area of the lateral cutaneous femoral nerve.
CONCLUSIONS: Treatment of anterior femoroacetabular impingement through an arthroscopically assisted mini-open anterior approach can reduce pain and improve function in a short-term observation period. Femoral osteochondroplasty as well as surgical treatment of acetabular cartilage and labrum lesions are possible, but the access is limited to the anterior and anterolateral part of the hip joint.
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