Researchers at Hospital for Special Surgery have found that arthroscopic treatment offemoroacetabular impingement yields outcomes similar to open surgery in terms of structural repair.
The study was published in the July issue of the American Journal of Sports Medicine.
“For the majority of patients with more typical hip impingement, arthroscopic approaches should be just as effective at adequately restoring the mechanics as the open surgical technique,” study co-author Bryan T. Kelly, MD, stated in a Hospital for Special Surgery press release.
Study methods and findings
Kelly’s team performed surgical treatment on 60 male patients younger than 40 years with symptomatic femoroacetabular impingement. Thirty patients were treated with arthroscopic cam and/or rim osteoplasty in addition to labral debridement and/or refixation. The other 30 patients were treated with open surgical dislocation, as well as cam and/or rim osteoplasty and labral debridement or refixation.
The team took preoperative and postoperative radiographs that measured depth and arc of resection as measured by assessment of the anterior femoral head-neck offset, anteroposterior and lateral alpha angle and beta angle.
Comparing the results, Kelly’s team found the arthroscopic group displayed a mean reduction in extended-neck lateral alpha angle of 28.3% and a mean anteroposterior alpha angle reduction of 16.8%. They also reported an improvement in anterior head-neck offset of 111% and a mean beta angle increase of 23.1°.
The open dislocation group, meanwhile, displayed a mean reduction in extended-neck lateral alpha angle of 30.7%, a mean anteroposterior alpha angle reduction of 25.7%, a 108% improvement in anterior head-neck offset and an 18.35° increase in mean beta angle.
Similar mechanical correction
The results, the authors noted, point toward arthroscopic osteoplasty being capable of restoring head-neck offset and achieving similar depth, arc and proximal-distal resection to those results seen through open surgical dislocation in cases of anterior and anterosuperior cam and focal rim impingement deformity.
“This is the first study in patients to show that we can achieve similar mechanical correction arthroscopically,” Kelly stated in the release.
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