Clin Orthop Surg.  2019 Sep;11(3):337-343. 10.4055/cios.2019.11.3.337.

Anterolateral Approach in the Treatment of Femoroacetabular Impingement of the Hip

Affiliations
  • 1Department of Orthopedic Surgery, Pediatric Orthopedics and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. kimht@pusan.ac.kr

Abstract

BACKGROUND
Ganz surgical hip dislocation via a posterior (Kocher-Langenbeck) approach is a popular procedure in the management of femoroacetabular impingement (FAI). We report the results of surgery performed through an anterolateral (Watson-Jones) approach in the management of anterolateral FAI.
METHODS
Twenty-one hips in 20 patients (mean age at the time of operation, 17.3 years) were treated surgically using an anterolateral approach: 12 hips with Legg-Calvé-Perthes disease, three septic hips, three hips with avascular necrosis (combined with slipped capital femoral epiphysis [SCFE], femoral neck fracture, and developmental dislocation of the hip), two hips with epiphyseal dysplasia, and one hip with SCFE. All patients had anterolateral FAI. Surgical hip dislocation was performed in four hips with trochanteric osteotomy. Combined osteotomies were for neck lengthening in 11 hips, varus or valgus osteotomy in the proximal femur in four hips, and pelvic osteotomy in four hips. Clinical results were evaluated using a modified Harris hip score (mHHS).
RESULTS
Range of hip flexion and abduction showed statistically significant improvement after surgery; however, the improvement in mean mHHS was not statistically significant.
CONCLUSIONS
An anterolateral approach can be used as an alternative to a posterior approach in the management of anterolateral FAI with or without hip dislocation while safely preserving the blood supply to the femoral head and allowing simultaneous procedures in the proximal femur.

Keyword

Femoroacetabular impingement; Hip dislocation

MeSH Terms

Dislocations
Femoracetabular Impingement*
Femoral Neck Fractures
Femur
Head
Hip Dislocation
Hip*
Humans
Legg-Calve-Perthes Disease
Neck
Necrosis
Osteotomy
Slipped Capital Femoral Epiphyses
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