ARTHROSCOPIC SURGICAL TREATMENT OF COXOFEMORAL CONFLIC VERSUS OPEN SURGERY: COMPARISON WITH AT LEAST 2 YEARS FOLLOW-UP

Abstract

Purpose of the study: Coxofemoral conflicts can sometimes lead to early degenerative disease in young patients. Open surgery for surgical dislocation with joint cleaning had provided promising short- and mid-term results. Arthroscopy of the hip joint is a less invasive alternative. The purpose of this work was to compare prospectively the outcome achieved with open surgical or arthroscopic treatment of coxofemoral conflicts after a minimum follow-up of two years.

Material and methods: Sixty-three patients, mean age 30 years (range 19–54) with arthroMRI-proven coxofemoral conflict were evaluated two years after treatment. Surgical dislocation was used for 31 patients and arthroscopy for 32. Clinical outcome was assessed on the basis of WOMAC scores noted preoperatively, postoperatively and at two years follow-up. Complications were noted.

Results: Results were similar in the two groups at two years: preoperative WOMAC score: 65/100 (41–95) pour open dislocation, 57/100 (15–96) for arthroscopy; postoperative WOMAC score at two years: 79/100 (41–99) for open dislocation, 84/100 (50–99) for arthroscopy. The rate of patient satisfaction was similar: (open dislocation: 75% and arthroscopy: 82%). Complications: open dislocation : 3 case of POA including 1 Brooker stage III and one 1 case of ossifying myositis of the thigh; arthroscopy: 2 case of hematoma (spontaneous resolution) and 1 case of transient irritation (48 h) of the lateral femoral cutaneous nerve. Surgical revisions at two years: open dislocation: one total hip arthroplasty at 15 months and one resection of ossification (POA) at 15 months; arthroscopy: two total hip arthroplasties at 5 and 15 months.

Discussion: The results obtained with the two methods are encouraging at two years. A satisfaction rate of 80% can be expected.

Conclusion: Arthroscopy appears to be the more advantageous alternative for young patients since it is less invasive and provides similar results at two years.