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


Zingg, Patrick O; Ulbrich, Erika J; Buehler, Tobias C; Kalberer, Fabian; Poutawera, Vaughan R; Dora, Claudio (2013). Surgical hip dislocation versus hip arthroscopy for femoroacetabular impingement: clinical and morphological short-term results. Archives of Orthopaedic and Trauma Surgery, 133(1):69-79.

Abstract

INTRODUCTION: Surgical hip dislocation (SHD) is an accepted standard to treat femoroacetabular impingement (FAI). However, arthroscopic techniques have gained widespread popularity and comparable results are reported. The purpose of this prospective comparative study was to test the hypothesis that, when compared to SHD, hip arthroscopy (HA) results in faster recovery, better short-term outcome, and equivalent morphological corrections. MATERIALS AND METHODS: 38 patients presenting with clinically and morphologically verified isolated FAI were allocated to either HA or SHD. Morphological evaluation consisted of pre- and postoperative X-rays, and arthro-MRI. Demographic data, sport activities, hospital stay, complications, and the time off work were recorded. The subjective hip value, WOMAC, HHS, and hip abductor strength were measured up to 1 year. RESULTS: Shorter hospital stay and time off work, less pain at 3 months and 1 year, higher subjective hip values at 6 weeks and 3 months, and better WOMAC at 3 months were seen after HA. The HHS and the hip abductor strengths were higher in the HA group. However, morphological corrections at the head-neck-junction achieved by HA showed some overcorrection when compared to SHD. Labral refixation was performed less frequent in the HA group. CONCLUSION: When compared to SHD, HA results in faster recovery and better short-term outcome. However, some overcorrection of the cam deformity and limited frequency of labrum refixation with HA in this study may have a negative impact on long-term outcome.

Abstract

INTRODUCTION: Surgical hip dislocation (SHD) is an accepted standard to treat femoroacetabular impingement (FAI). However, arthroscopic techniques have gained widespread popularity and comparable results are reported. The purpose of this prospective comparative study was to test the hypothesis that, when compared to SHD, hip arthroscopy (HA) results in faster recovery, better short-term outcome, and equivalent morphological corrections. MATERIALS AND METHODS: 38 patients presenting with clinically and morphologically verified isolated FAI were allocated to either HA or SHD. Morphological evaluation consisted of pre- and postoperative X-rays, and arthro-MRI. Demographic data, sport activities, hospital stay, complications, and the time off work were recorded. The subjective hip value, WOMAC, HHS, and hip abductor strength were measured up to 1 year. RESULTS: Shorter hospital stay and time off work, less pain at 3 months and 1 year, higher subjective hip values at 6 weeks and 3 months, and better WOMAC at 3 months were seen after HA. The HHS and the hip abductor strengths were higher in the HA group. However, morphological corrections at the head-neck-junction achieved by HA showed some overcorrection when compared to SHD. Labral refixation was performed less frequent in the HA group. CONCLUSION: When compared to SHD, HA results in faster recovery and better short-term outcome. However, some overcorrection of the cam deformity and limited frequency of labrum refixation with HA in this study may have a negative impact on long-term outcome.

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22 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:13 Dec 2012 09:54
Last Modified:05 Apr 2016 16:10
Publisher:Springer
ISSN:0936-8051
Publisher DOI:https://doi.org/10.1007/s00402-012-1616-2
PubMed ID:23064993

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