PURELY ARTHROSCOPIC TREATMENT OF COXOFEMORAL CONFLICTS: SURGICAL TECHNIQUE AND COMPLICATIONS

Abstract

Purpose of the study: Coxofemoral conflicts can sometimes lead to early degenerative disease in young patients. Hip arthroscopy is a less invasive alternative which can remove all of the coxofemoral conflicts. Like open surgery, a purely arthroscopic technique enables all the necessary corrections, even involving the rim. Arthroscopy has provides promising short- and mid-term results. The purpose of this work was to present the surgical technique, its drawbacks and complications, and present suggestions for improvement.

Material and methods: Fifty-one patients, mean age 31 years (range 15–54 years) underwent purely arthroscopic treatment of coxofemoral conflicts between February 2001 and November 2003. Prospective follow-up was at least six months. The type of conflict and the corresponding corrections were noted. The Pre- and postoperative WOMAC scores were used for clinical assessment. Complications were noted as well as means for avoiding them.

Results: The operative technique, the potential dangers, and suggestions for successful arthroscopy are presented. The clinical outcome with at least six months follow-up was: hip R/L: 21/31. Head and acetabular correction: 46 cases. Head correction alone (head/neck offset): 5 cases. Preoperative WOMAC score: 59/100 (15–99). Postoperative WOMAC score: 85/100 (49–99). Complications: spontaneously resolutive hematoma (n=2), transient (48h) irritation of the lateral femoral cutaneous nerve (n=1).

Discussion: Purely arthroscopic correction of a coxofemoral conflict is as safe as the open surgical technique. The arthroscopic method provides very promising short- and mid-term results with no major complications. The lower morbidity with this technique enables ambulatory treatment with shorter recovery time.