Midterm outcomes in patients with cam femoroacetabular impingement treated arthroscopically.

Abstract

PURPOSE:

The purpose of this study was to evaluate the midterm outcomes of patients with cam-type femoroacetabular impingement treated arthroscopically.

METHODS:

Outcomes were measured with the Nonarthritic Hip Score (NAHS), visual analog scale pain scores, and satisfaction levels preoperatively; at 6 weeks and 3, 6, 12, and 24 months postoperatively; and at final follow-up. Two hundred one procedures were available for final assessment with a minimum follow-up of 36 months (mean, 46 months). Ninety-nine percent of hips had a preoperative Tönnis grade of 1 or less.

RESULTS:

The NAHS significantly improved from a mean of 56.1 to 78.2 (P < .001). Visual analog scale pain scores improved from a mean of 6.8 to 2.7 (P < .001). Preoperative to postoperative satisfaction levels improved from 0.5% to 75% of procedures. Twelve patients required hip arthroplasty during the follow-up period and had a higher incidence of grade 4 acetabular chondral defects versus those without arthroplasty (P < .03). Patients with pincer resections had significantly poorer results versus the remainder of the cohort (P < .01).

CONCLUSIONS:

We have shown satisfactory results using a validated hip scoring system, showing improvement in NAHS, pain scores, and satisfaction levels in a large cohort of patients with cam-type femoroacetabular impingement followed up for a mean of 46 months. The results have shown improvement and stability throughout a range of 36 to 70 months' follow-up. There was no difference in preoperative to postoperative NAHS between age groups. There was a larger percentage of grade 4 acetabular chondral defects in those patients who needed conversion to hip arthroplasty. Patients with associated pincer pathology had poorer results after acetabular rim resection.

LEVEL OF EVIDENCE:

Level IV, therapeutic case series.

• Authors: David H Palmer, Vishal Ganesh, Thomas Comfort, Penny Tatman
• Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association (Arthroscopy) Vol. 28 Issue 11 Pg. 1671-81 (Nov 2012) ISSN: 1526-3231 [Electronic] United States
• PMID: 22959221 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Age Distribution
• Aged
• Aged, 80 and over
• Arthroscopy (methods)
• Female
• Femoracetabular Impingement (diagnosis, physiopathology, surgery)
• Follow-Up Studies
• Hip Joint (physiopathology)
• Humans
• Male
• Middle Aged
• Pain Measurement
• Patient Satisfaction (statistics & numerical data)
• Range of Motion, Articular
• Sex Distribution
• Treatment Outcome
• Young Adult