Results of Arthroscopic Treatment for Femoroacetabular Impingement

Oleg E. Bogopolskiy; Богопольский Олег Евгеньевич; Pavel A. Trachuk; Трачук Павел Александрович; Denis V. Spetsialnyi; Специальный Денис Владимирович; Andrei P. Sereda; Середа Андрей Петрович; Rashid M. Tikhilov; Тихилов Рашид Муртузалиевич

doi:10.17816/2311-2905-1980

Results of Arthroscopic Treatment for Femoroacetabular Impingement

Authors: Bogopolskiy O.E.¹, Trachuk P.A.¹, Spetsialnyi D.V.¹, Sereda A.P.¹^,2, Tikhilov R.M.¹
Affiliations:
1. Vreden National Medical Research Center of Traumatology and Orthopedics
2. Academy of Postgraduate Education of Federal Medical Biological Agency
Issue: Vol 28, No 4 (2022)
Pages: 54-65
Section: Clinical studies
URL: https://bakhtiniada.ru/2311-2905/article/view/124760
DOI: https://doi.org/10.17816/2311-2905-1980
ID: 124760

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Abstract

Background. Femoroacetabular impingement (FAI) is one of the most frequent causes of hip pain and limited hip mobility in young and middle-aged patients. It is a result of repeated injury of hip structures, that leads to degenerative changes in hip labrum, cartilage and subchondral bone and provokes progressive development of hip osteoarthritis.

Aim of study — to analyze own experience of treating patients with femoroacetabular impingement and identify factors affecting its outcomes.

Methods. Retrospective, uncontrolled, single-center clinical study included 128 patients with FAI which had 150 surgeries on 149 joints in in the period from 2013 to 2021. All patients underwent physical examination and X-ray diagnostics, their FAI type was identified. The alpha angle of external part of femoral head in anterior-posterior position and in the modified Dunn 45° position, as well as Tonnis angle, lateral central-marginal angle in Ogata modification and the height of articular gap along the lateral (LS) and medial edges (MS) of sclerosed acetabulum part were calculated. The i-HOT-33 and HOS scales were used to assess preoperative status and postoperative results.

Results. The average follow-up period was 3.9 years (SD 1.71; min 1.05 and max 8.16). The study included 55 (43.0%) women and 73 (57.0%) men which underwent 64 (42.7%) and 86 (57.3%) surgeries respectively. The most common types of FAI, according to our data, were mixed type (53% of joints) and сam type (27.5% of joints). Insufficient coverage of the femoral head by the acetabulum (borderline dysplasia) in combination with the сam deformity of the femoral head was observed in 18.1%. Pincer-type FAI was observed in 1.4% of joints. We obtained the worst results with a combination of сam deformity and borderline dysplasia in comparison with cam- and mix-type FAI according to the i-HOT-33 and HOS scales. Patients’ age, deep cartilage damage, irreparable labrum damage and height decrease of the lateral part of the articular gap determined negative effect on treatment results according to the i-HOT-33 and HOS scales.

Conclusion. Hip arthroscopy showed good short- and midterm outcomes in patients with FAI. Pain syndrome is most often manifested in patients with pathology of hip soft tissue structures concomitant to FAI. The combination of сam deformity and insufficient femoral head coverage, deep cartilage damage and a height decrease of the articular gap are important predictors of poor treatment results.

Keywords

arthroscopy, femoroacetabular impingement, pincer deformity, cam deformity, hip dysplasia, retroversion

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##article.viewOnOriginalSite##

Dr. Sci. (Med.)

Russian Federation, St. Petersburg; Moscow

Rashid M. Tikhilov

Vreden National Medical Research Center of Traumatology and Orthopedics

Email: rtikhilov@gmail.com
ORCID iD: 0000-0003-0733-2414

Dr. Sci. (Med.), Professor

Russian Federation, St. Petersburg

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