ARTHROSCOPIC FEMORAL OSTEOCHONDROPLASTY FOR CAM LESIONS WITH ISLOATED ACETABULAR CHONDRAL DAMAGE

Abstract

Purpose: The purpose of this study was to evaluate the outcome of arthroscopic femoral osteochondroplasty for cam lesions of the hip with respect to the severity of acetabular chondral damage.

Methods: The study is a retrospective review of 170 patients (35 females, 135 males) who underwent surgery for symptomatic cam femoroacetabular impingement (FAI) between the years 2003 to 2008. The patients were categorized according to three different grades of chondral damage. No patients had evidence of labral pathology. Microfracture of the acetabular chondral damage was also performed when indicated. The clinical results in each grade were measured preoperatively and postoperatively with the modified Harris Hip Score (MHHS) and Non Arthritic Hip Score (NAHS).

Results: The mean follow-up time was 22 months (range 12 to 72 months). At the last follow-up, significantly better results were observed in hips with less chondral damage. The mean MHHS improved from 74.1±17.1 to 89.8±11.6 in grade 1 whereas it improved from 62.3±14.3 to 77.4±18.3 in grade 3 (p=0.02). The mean NAHS improved from 70.7±13.5 to 87±16.2 in grade 1 whereas it improved from 60.5±16.2 to 78±17.8 in grade 3 (p=0.04). Microfracture in limited zones of ace-tabular chondral damage had shown superior results.

Conclusions: Arthroscopic femoral osteoplasty for hip cam impingement with acetabular chondral damage provides a significant improvement in symptoms. Microfracture of the chondral lesion in selected cases has been demonstrated to be safe and benifical.