Hip Pelvis.  2014 Mar;26(1):29-35. 10.5371/hp.2014.26.1.29.

Arthroscopic Treatment of Cam Type Femoroacetabular Impingement: Short Term Results

Affiliations
  • 1Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea. femur1973@hanmail.net

Abstract

PURPOSE
We evaluated the short term results after treatment of cam type femoroacetabular impingement (FAI) by arthroscopy.
MATERIALS AND METHODS
We evaluated the clinical and radiological results of arthroscopically treated cam type FAI in patients who had failed conservative treatment with hip pain, with at least 12 months follow-up, from November 2010 to December 2012. There were 19 males and six females. Mean age of patients was 32.9 years (19-57 years) and mean follow up period was 17.2 months (13-31 months). We analyzed the alpha angle, head neck offset, visual analogue scale (VAS), and modified Harris hip score (MHHS).
RESULTS
Mean alpha angle improved from 64.8degrees to 39.9degrees and mean head neck offset also improved from 0.8 to 7.6 mm. Peripheral longitudinal and radial fibrillated labral tear was the most common in the anterosuperior quadrant. Damage to acetabular cartilage was identified in 14 patients. Mean VAS improved from 6.3 to 0.9 and mean MHHS improved from 51.7 to 73.6. Complications associated with the operation included three cases of femoral head articular cartilage injury, two cases of pudendal nerve injury, and two cases of lateral femoral cutaneous nerve injury.
CONCLUSION
Although the short term results for arthroscopically treated cam type FAI were satisfactory, care must be taken to reduce the complications associated with arthroscopy and long term follow is needed in order to determine whether or not it can reduce osteoarthritis of the hip.

Keyword

Cam type; Femoroacetabular impingement; Arthroscopic treatment

MeSH Terms

Acetabulum
Arthroscopy
Cartilage
Cartilage, Articular
Female
Femoracetabular Impingement*
Follow-Up Studies
Head
Hip
Humans
Male
Neck
Osteoarthritis
Pudendal Nerve

Figure

  • Fig. 1 Arthroscopic finding shows the labral contusion (arrow head) and peripheral longitudinal tear (arrow) at anterosuperior quadrant of the acetabulum.

  • Fig. 2 Variable articular cartilage lesions. According to Outerbridge classification, (A) grade 2 partial thickness defect of cartilage (arrow); (B) grade 3 partial thickness defect with diameter more than 1.5 cm (arrow head); and (C) grade 4 full thickness acetabular cartilage defect (asterisk) can be seen.

  • Fig. 3 Pre-operative anteroposterior (A) and frog leg (B) radiographs of the left hip show asphericity of femoral head and mild pistol-grip deformity and negative head-neck offset and alpha-angle. Alpha angle is shown at B and D. Post-operative anteroposterior (C) and frog leg (D) radiographs show restored sphericity of the femoral head and restored impingement free head-neck offset. The head-neck offset is distance between two parallel lines (B, D).

  • Fig. 4 Alpha angle is shown at oblique axial view of the femur neck on computed tomogram.


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