Surgical Treatment of Femoroacetabular Impingement

Background:. Femoroacetabular impingement (FAI) is a well-known cause of hip pain and dysfunction in young adults. Surgical treatment has been widely popularized during the past decade. However, most reported results have been limited to short-term and intermediate-term follow-up. The long-term succ...

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Autores principales:	Hamed Vahedi, MD, Steven Yacovelli, Claudio Diaz, MD, Javad Parvizi, MD, FRCS
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/c860a97d25084bf18f7427a0ed2d7e7a
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spelling	oai:doaj.org-article:c860a97d25084bf18f7427a0ed2d7e7a2021-11-25T07:59:02ZSurgical Treatment of Femoroacetabular Impingement2472-724510.2106/JBJS.OA.20.00176https://doaj.org/article/c860a97d25084bf18f7427a0ed2d7e7a2021-12-01T00:00:00Zhttp://journals.lww.com/jbjsoa/fulltext/10.2106/JBJS.OA.20.00176https://doaj.org/toc/2472-7245Background:. Femoroacetabular impingement (FAI) is a well-known cause of hip pain and dysfunction in young adults. Surgical treatment has been widely popularized during the past decade. However, most reported results have been limited to short-term and intermediate-term follow-up. The long-term success rate and risk factors for failure are largely unknown. This study aimed to report the long-term (minimum, 10 years) clinical outcomes of surgical treatment of FAI and to describe the clinical and radiographic parameters associated with the failure of treatment involving femoroacetabular osteoplasty (FAO) and labral repair. Methods:. Using our prospective hip preservation database, 164 patients (178 hips) who had undergone FAO between January 2005 and April 2009 were identified. Patient demographic characteristics, clinical history, duration of preoperative symptoms, radiographic parameters (preoperative and postoperative alpha angles, hip dysplasia and retroversion, Tönnis grade for osteoarthritis), and intraoperative findings were reviewed and compared between the success and failure groups. At a minimum 10-year follow-up, clinical functional outcomes (modified Harris hip score [mHHS] and Short Form-36 [SF-36] at 6 weeks, 6 months, 1 year, and 10 years) and failure rates (conversion to total hip arthroplasty [THA]) were collected. Results:. The mean patient age (and standard deviation) was 34.3 ± 8.4 years, and 65 patients (40%) were female. After the surgical procedure, there was significant improvement in the mean mHHS (59.3 ± 7.3 points preoperatively to 88.4 ± 7.3 points postoperatively) and the mean SF-36 (61.3 ± 8.4 points preoperatively to 89.1 ± 7.2 points postoperatively). At a mean follow-up of 12.5 years, 12% (22 hips) required conversion to THA, with a mean time to THA of 5.3 ± 2.0 years. Older age, longer preoperative symptomatic period, higher preoperative and postoperative alpha angles, presence of hip dysplasia, a higher Tönnis grade, joint space narrowing, and a full-thickness acetabular chondral lesion at the time of the FAO were identified as risk factors for failure and conversion to THA. Conclusions:. Patients with symptomatic FAI who undergo a surgical procedure experience pain relief and functional improvement that appear to endure over a decade in the majority of patients. This study on a relatively large cohort with a long-term follow-up has also identified patients who are at a higher risk for treatment failure. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.Hamed Vahedi, MDSteven YacovelliClaudio Diaz, MDJavad Parvizi, MD, FRCSWolters KluwerarticleOrthopedic surgeryRD701-811ENJBJS Open Access, Vol 6, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Hamed Vahedi, MD Steven Yacovelli Claudio Diaz, MD Javad Parvizi, MD, FRCS Surgical Treatment of Femoroacetabular Impingement
description	Background:. Femoroacetabular impingement (FAI) is a well-known cause of hip pain and dysfunction in young adults. Surgical treatment has been widely popularized during the past decade. However, most reported results have been limited to short-term and intermediate-term follow-up. The long-term success rate and risk factors for failure are largely unknown. This study aimed to report the long-term (minimum, 10 years) clinical outcomes of surgical treatment of FAI and to describe the clinical and radiographic parameters associated with the failure of treatment involving femoroacetabular osteoplasty (FAO) and labral repair. Methods:. Using our prospective hip preservation database, 164 patients (178 hips) who had undergone FAO between January 2005 and April 2009 were identified. Patient demographic characteristics, clinical history, duration of preoperative symptoms, radiographic parameters (preoperative and postoperative alpha angles, hip dysplasia and retroversion, Tönnis grade for osteoarthritis), and intraoperative findings were reviewed and compared between the success and failure groups. At a minimum 10-year follow-up, clinical functional outcomes (modified Harris hip score [mHHS] and Short Form-36 [SF-36] at 6 weeks, 6 months, 1 year, and 10 years) and failure rates (conversion to total hip arthroplasty [THA]) were collected. Results:. The mean patient age (and standard deviation) was 34.3 ± 8.4 years, and 65 patients (40%) were female. After the surgical procedure, there was significant improvement in the mean mHHS (59.3 ± 7.3 points preoperatively to 88.4 ± 7.3 points postoperatively) and the mean SF-36 (61.3 ± 8.4 points preoperatively to 89.1 ± 7.2 points postoperatively). At a mean follow-up of 12.5 years, 12% (22 hips) required conversion to THA, with a mean time to THA of 5.3 ± 2.0 years. Older age, longer preoperative symptomatic period, higher preoperative and postoperative alpha angles, presence of hip dysplasia, a higher Tönnis grade, joint space narrowing, and a full-thickness acetabular chondral lesion at the time of the FAO were identified as risk factors for failure and conversion to THA. Conclusions:. Patients with symptomatic FAI who undergo a surgical procedure experience pain relief and functional improvement that appear to endure over a decade in the majority of patients. This study on a relatively large cohort with a long-term follow-up has also identified patients who are at a higher risk for treatment failure. Level of Evidence:. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
format	article
author	Hamed Vahedi, MD Steven Yacovelli Claudio Diaz, MD Javad Parvizi, MD, FRCS
author_facet	Hamed Vahedi, MD Steven Yacovelli Claudio Diaz, MD Javad Parvizi, MD, FRCS
author_sort	Hamed Vahedi, MD
title	Surgical Treatment of Femoroacetabular Impingement
title_short	Surgical Treatment of Femoroacetabular Impingement
title_full	Surgical Treatment of Femoroacetabular Impingement
title_fullStr	Surgical Treatment of Femoroacetabular Impingement
title_full_unstemmed	Surgical Treatment of Femoroacetabular Impingement
title_sort	surgical treatment of femoroacetabular impingement
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/c860a97d25084bf18f7427a0ed2d7e7a
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Surgical Treatment of Femoroacetabular Impingement

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