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Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications.

Roos BD, Roos MV, Júnior AC, Lima EM, Gyboski DP, Martins LS - Rev Bras Ortop (2015)

Bottom Line: There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001).Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001).Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brazil.

ABSTRACT

Objectives: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach.

Methods: Between January 2011 and March 2012, 49 patients (50 hips) underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips) fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS), the Non-Arthritic Hip score (NAHS) and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip.

Results: Out of the 41 hips treated, 31 (75.6%) presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001). Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001).

Conclusion: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

No MeSH data available.


Related in: MedlinePlus

Arthroscopic image of the left hip during operation to treat FAI, by means of an extracapsular approach. Exposure of the joint capsule (JC) and identification of the reflex portion of the rectus femoris muscle (RF). The anatomical location of this muscle generally marks the proximity of the labrum of the hip, below the capsule.
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fig0005: Arthroscopic image of the left hip during operation to treat FAI, by means of an extracapsular approach. Exposure of the joint capsule (JC) and identification of the reflex portion of the rectus femoris muscle (RF). The anatomical location of this muscle generally marks the proximity of the labrum of the hip, below the capsule.

Mentions: With the hip extended and using two arthroscopic portals, the anterior joint capsule and iliocapsularis muscle were dissected using radiofrequency and a shaver, until adequate exposure had been achieved. Identification of the reflex portion of the rectus femoris muscle marked the location of the acetabular labrum (Fig. 1). Capsulotomy was then performed longitudinally as far as the femoral neck, which may also be extended as necessary during the operation (Fig. 2). Capsulectomy was then performed, followed by femoral and/or acetabular osteochondroplasty. The limb was placed under traction at the time of inspection of the central compartment and labral refixation when necessary, in accordance with Fryer and Domb20 (Fig. 3). After the procedure, suturing of the capsule could be done if necessary.


Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications.

Roos BD, Roos MV, Júnior AC, Lima EM, Gyboski DP, Martins LS - Rev Bras Ortop (2015)

Arthroscopic image of the left hip during operation to treat FAI, by means of an extracapsular approach. Exposure of the joint capsule (JC) and identification of the reflex portion of the rectus femoris muscle (RF). The anatomical location of this muscle generally marks the proximity of the labrum of the hip, below the capsule.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563045&req=5

fig0005: Arthroscopic image of the left hip during operation to treat FAI, by means of an extracapsular approach. Exposure of the joint capsule (JC) and identification of the reflex portion of the rectus femoris muscle (RF). The anatomical location of this muscle generally marks the proximity of the labrum of the hip, below the capsule.
Mentions: With the hip extended and using two arthroscopic portals, the anterior joint capsule and iliocapsularis muscle were dissected using radiofrequency and a shaver, until adequate exposure had been achieved. Identification of the reflex portion of the rectus femoris muscle marked the location of the acetabular labrum (Fig. 1). Capsulotomy was then performed longitudinally as far as the femoral neck, which may also be extended as necessary during the operation (Fig. 2). Capsulectomy was then performed, followed by femoral and/or acetabular osteochondroplasty. The limb was placed under traction at the time of inspection of the central compartment and labral refixation when necessary, in accordance with Fryer and Domb20 (Fig. 3). After the procedure, suturing of the capsule could be done if necessary.

Bottom Line: There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001).Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001).Abstract available from the publisher.

View Article: PubMed Central - PubMed

Affiliation: Hospital Ortopédico de Passo Fundo, Passo Fundo, RS, Brazil.

ABSTRACT

Objectives: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach.

Methods: Between January 2011 and March 2012, 49 patients (50 hips) underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips) fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS), the Non-Arthritic Hip score (NAHS) and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip.

Results: Out of the 41 hips treated, 31 (75.6%) presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4̊ for the internal rotation of the hip (p < 0.001). Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9̊ and mean increase of 0.10, respectively (p < 0.001).

Conclusion: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

No MeSH data available.


Related in: MedlinePlus