Anterior Femoroacetabular Impingement

TLDR

Femoroacetabular impingement causes labral and chondral lesions that can lead to hip osteoarthritis. Eliminating the pathogenic cause may prevent or delay further hip degeneration. Nineteen patients (14 men, 5 women, mean age 36) underwent surgical dislocation with offset creation and were followed for an average of 4.7 years. At a mean 4.7‑year follow‑up, 13 hips scored excellent to good with pain improvement, no avascular necrosis, and no further joint space narrowing in stable hips, while 5 patients required total hip arthroplasty; the procedure is effective for early osteoarthritis (≤Grade 1) but unsuitable for advanced degeneration.

Abstract

Femoroacetabular impingement has been shown to cause labral and chondral lesions and leads to osteoarthrosis of the hip. With the elimination of the pathogenic cause we hope to prevent or delay additional degeneration of the hip. Fourteen men and five women with a mean age of 36 years (range, 21-52 years) were treated with a surgical dislocation and offset creation of the hip. The followup averaged 4.7 years (range, 4-5.2 years). Using the Merle d'Aubigné hip score, 13 hips were rated excellent to good, with the pain score improving from 2.9 points to 5.1 points at the latest followup. There was no avascular necrosis of the femoral head. Five of the 19 patients, two with Grade 2 osteoarthrosis, two with Grade 1 osteoarthrosis but severe acetabular cartilage damage, and one with untreated ossified labrum had subsequent total hip arthroplasty (THA). In the stable hips without subluxation of the head into the acetabular cartilage defect, no additional joint space narrowing occurred. Surgical dislocation with correction of femoroacetabular impingement yields good results in patients with early degenerative changes not exceeding Grade 1 osteoarthrosis. This procedure is not suitable for patients with advanced degenerative changes and extensive articular cartilage damage.