Clin Orthop Surg.  2009 Sep;1(3):146-154. 10.4055/cios.2009.1.3.146.

Treatment of Femoroacetabular Impingement with Surgical Dislocation

• Yun HH
• Shon WY
• Yun JY

• KMID: 999393
• DOI: http://doi.org/10.4055/cios.2009.1.3.146

Abstract

BACKGROUND
The authors report the results of femoroacetabular impingement (FAI) treated with a surgical dislocation. METHODS: From April 2005 to May 2007, 15 FAI hips were treated with a surgical dislocation. The male/female ratio, mean age and mean symptom duration was 12/2, 35.8 years and 2.3 years, respectively. Radiographs and MR arthrograms were taken. The clinical evaluation involved changes in the pre- and postoperative Harris hip score (HHS). RESULTS: There were 12 hips (80%) with at least one structural abnormality in the radiographs, with 11 (79%) labral tears and 8 (73%) abnormally high angles in the MR arthrograms. We performed 15 osteochondroplasties, 12 labral repairs, 12 acetabuloplasty, and 3 debridements. The mean HHS improved from 76 to 93 points. Three non-unions of the trochanteric osteotomy sites were encountered as complications. CONCLUSIONS: Radiographs and MR arthrograms are important for making a proper diagnosis of FAI and planning treatment. A surgical dislocation can be used to treat FAI but further technical improvements will be needed for fixation of the greater trochanteric osteotomy sites.

Keyword

Hip; Femoroacetabular impingement; Surgical dislocation

MeSH Terms

Acetabulum/surgery
Adult
Female
Femoracetabular Impingement/radiography/*surgery
Femur Head/surgery
Humans
Ligaments, Articular/surgery
Male
Middle Aged
Orthopedic Procedures/methods
Osteotomy
Treatment Outcome
Young Adult

Figure

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  Fig. 1 Both hip anteroposterior radiograph of a 25-year old male who suffered from left hip joint pain for 3 years shows a positive crossover sign in both hip areas.

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  Fig. 2 MR arthrogram in the T1-weighted image shows a labral tear at the anterosuperior portion.

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  Fig. 3 Intraoperative findings. (A) Labral tear was detected by a probe. (B) Acetabuloplasty of the anterosuperior of acetabular rim was performed. (C) Labral repair was done using an anchor suture. (D) Osteochondroplasty was performed at the anterolateral side of the femoral head-neck junction.

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  Fig. 4 Postoperative radiograph shows union of the osteotomy site and no arthritic changes.

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  Fig. 5 Both hip anteroposterior radiograph of a 46-year old male who suffered from left hip joint pain from 10 years ago shows a positive crossover sign in the right hip area.

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  Fig. 6 The pre- and postoperative MRIs shows a well-healed labral lesion and the amount of osteochondroplasty. In addition, there was no low-intensity signal, collapsed femoral head or double-line sign.

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