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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

Male patient aged 32 years. Preoperative internal rotation of 5°. (A, B) Preoperative radiographs showing FAI of cam type, θCE: 27° and θα: 68°. (C, D) Radiographs produced 3 years and 2 months after the operation, in which femoral osteochondroplasty had been performed in association with labral debridement. The patient evolved well, to internal rotation of 18°, with normalization of θα.
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fig0020: Male patient aged 32 years. Preoperative internal rotation of 5°. (A, B) Preoperative radiographs showing FAI of cam type, θCE: 27° and θα: 68°. (C, D) Radiographs produced 3 years and 2 months after the operation, in which femoral osteochondroplasty had been performed in association with labral debridement. The patient evolved well, to internal rotation of 18°, with normalization of θα.

Mentions: As complications, we found one case (2.43%) of deep vein thrombosis, one case (2.43%) of heterotopic ossification classified as grade 3 by Brooker19 and one case (2.43%) of transitory paresthesia of the pudendal nerve (with regression 2 months after the operation). Two cases (4.87%) presented persistent pain, and one of these now has been indicated for total hip arthroplasty. Both of these cases were patients with arthrosis of Tönnis grade 2 (Fig. 4, Fig. 5).


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)

Male patient aged 32 years. Preoperative internal rotation of 5°. (A, B) Preoperative radiographs showing FAI of cam type, θCE: 27° and θα: 68°. (C, D) Radiographs produced 3 years and 2 months after the operation, in which femoral osteochondroplasty had been performed in association with labral debridement. The patient evolved well, to internal rotation of 18°, with normalization of θα.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

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

fig0020: Male patient aged 32 years. Preoperative internal rotation of 5°. (A, B) Preoperative radiographs showing FAI of cam type, θCE: 27° and θα: 68°. (C, D) Radiographs produced 3 years and 2 months after the operation, in which femoral osteochondroplasty had been performed in association with labral debridement. The patient evolved well, to internal rotation of 18°, with normalization of θα.
Mentions: As complications, we found one case (2.43%) of deep vein thrombosis, one case (2.43%) of heterotopic ossification classified as grade 3 by Brooker19 and one case (2.43%) of transitory paresthesia of the pudendal nerve (with regression 2 months after the operation). Two cases (4.87%) presented persistent pain, and one of these now has been indicated for total hip arthroplasty. Both of these cases were patients with arthrosis of Tönnis grade 2 (Fig. 4, Fig. 5).

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