CLINICAL RESULTS OF FEMORAL HEAD/NECK CHONDRO-OSTEOPLASTY FOR FEMOROACETABULAR IMPINGEMENT.

Abstract

Thirty-seven hips in thirty-four patients, mean age forty-one, underwent surgical dislocation of the hip with chondro-osteoplasty for the treatment of femoroacetabular impingement. At a mean follow-up of 2.1 years (2.0–4.0), the pre & post-operative outcome scores were for the: WOMAC 59.2 to 81.0 (p< 0.001), UCLA Hip Scores for pain 4.2 to 7.6;walking 7.3 to 8.6;function 6.2 to 8.1;activity level 4.3 to 6.9 (p< 0.05); and SF-12 physical 37.4 to 48.0 (p< 0.003) & mental 46.0 to 51.6 (p< 0.01). No hips have undergone further reconstructive surgery. Complications: one failure of fixation of the trochanteric osteotomy and one excision of bilateral ectopic ossification. No cases of osteonecrosis.

The purpose of our study was to evaluate the early clinical results and quality of life outcome after chondro-osteoplasty of the femoral head/neck junction for the treatment of femoroacetabular impingement.

An offset correction by surgical dislocation of the hip joint is a safe and an effective procedure in the treatment of femoroacetabular impingement commonly associated with labral tears.

Femoro acetabular impingement is a due to an absence of concavity at the anterolateral head neck junction associated with labral pathology. At short-term followup correction of the bony abnormality has improved functional outcome both from a disease-specific and health-related standpoint.

Thirty-seven hips (eighteen males; sixteen females) with persistent hip pain mean age forty-one (twenty-four to fifty-two) underwent 3-Dimensional CT of the pelvis and MR Arthrography prior to undergoing surgical dislocation with chondro-osteoplasty of the femoral head/neck junction. Preoperatively, the mean alpha angle of Notzli was 65.6(range, 42.0–95). At a mean follow-up of 2.1 years (2.0–4.0), the pre & post-operative outcome scores were for the: WOMAC 59.2 to 81.0 (p< 0.001), UCLA Hip Scores for pain 4.2 to 7.6;walking 7.3 to 8.6;function 6.2 to 8.1;activity level 4.3 to 6.9 (p< 0.05); and SF-12 physical 37.4 to 48.0 (p< 0.003) & mental 46.0 to 51.6 (p< 0.01). No hips have undergone further reconstructive surgery. Complications: one failure of fixation of the trochanteric osteotomy and one excision of bilateral ectopic ossification. No cases of osteonecrosis. Nine hips had removal of painful internal fixation.